Evidence map›Paper›PMID 40542940›Full record

SynthesisAnatomical science international2026

Anatomical variants of the vertebral artery and their relationship with craniocervical disorders and surgical considerations: a systematic review and meta-analysis.

Juan José Valenzuela-Fuenzalida, Javiera Del Villar-Valdebenito, Lorenzo Aburto, Fernanda Berríos, Diego Nazar Izquierdo, Macarena Rodriguez- Luengo, Maja Czerniachowska, Pablo Nova Baeza, Mathias Orellana-Donoso, Alejandra Suazo-Santibañez and 4 more

Abstract readSystematic ReviewMeta-AnalysisReview
PubMed Publisher
In one paragraph

Synthesis in Anatomical science international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Juan José Valenzuela-FuenzalidaDepartamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Avenida Republica 275, 8370146, Santiago, Chile. Juan.kine.2015@gmail.com.ORCID http://orcid.org/0000-0002-7634-012X
Javiera Del Villar-ValdebenitoFacultad de Medicina, Universidad Mayor, 8580745, Santiago, Chile.
Lorenzo AburtoFacultad de Medicina, Universidad Mayor, 8580745, Santiago, Chile.
Fernanda BerríosFacultad de Medicina, Universidad Mayor, 8580745, Santiago, Chile.
Diego Nazar IzquierdoDepartamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Avenida Republica 275, 8370146, Santiago, Chile.
Macarena Rodriguez- LuengoDepartamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Avenida Republica 275, 8370146, Santiago, Chile.
Maja CzerniachowskaDepartamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Avenida Republica 275, 8370146, Santiago, Chile.
Pablo Nova BaezaDepartamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Avenida Republica 275, 8370146, Santiago, Chile.
Mathias Orellana-DonosoDepartamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Avenida Republica 275, 8370146, Santiago, Chile.
Alejandra Suazo-SantibañezDepartment of Morphology and Function, Faculty of Health and Social Sciences, Universidad de Las Américas, 8370040, Santiago, Chile.
Alejandro Bruna-MejiasDepartamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Avenida Republica 275, 8370146, Santiago, Chile.
Gustavo Oyanedel-AmaroFacultad de Ciencias de la Salud, Universidad Autónoma de Chile, 8910060, Santiago, Chile.
Heather F SmithDepartment of Anatomy, Midwestern University, Glendale, 19555 N. 59th Ave, AZ, 85308, USA.
Juan Sanchis-GimenoGIAVAL Research Group, Department of Anatomy and Human Embryology, Faculty of Medicine, University of Valencia, 46001, Valencia, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The vertebral artery (VA) supplies almost one-third of the blood flow to the brain, contributing mainly to its posterior circulation. This article provides a comprehensive overview of the different anatomical variations related to the origin, course, and termination of the VA and associated clinical implications. Data were compiled from numerous published studies accessed from the databases Medline, Scopus, Web of Science, Google Scholar, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Literature in Health Sciences (LILACS) as of January 2024. Methodological quality was evaluated with an assurance tool for anatomical studies (AQUA). Pooled prevalence was estimated using a random effects model, and differences in VA variant rates were assessed. VA variants were identified that could be separated into three categories: variation in origin, course, and terminal branches. A total of 16 studies met the established selection criteria for the current meta-analysis. VA variations were reported at an overall prevalence of 11% (CI: 7%-15%) and a heterogeneity of 77%. Statistically significantly higher rates were revealed in the following subgroups of the sample: imaging examinations versus cadavers (p = 0.032); right side of the body versus left (p = 0.034); and bilaterally versus unilaterally (p = 0.019). Concerns listed in included studies primarily focused on the possibility of iatrogenic damage during surgical procedures. A few studies also indicated higher rates of VA variants in patients who reported symptoms of recurrent headaches, vertigo, dizziness, and/or syncope. The presence of VA variants is high and can occur in various regions. However, the most important clinical consideration is that individuals with this variant must be constantly monitored since their posterior cerebral circulation could be affected. To avoid iatrogenic damage to the VA, clinicians should employ medical imaging to evaluate its course and branches prior to surgical interventions in the region.

Indexed as

Anatomic VariationVertebral ArteryHumansAberrant vertebral arteryAnatomical variationAnatomyClinical anatomyVertebral arteryVertebral artery variation

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.