Evidence map›Paper›PMID 40615584›Full record

ArticleSurgical and radiologic anatomy : SRA2025

Rare origin of the left vertebral artery from distal thoracic aorta and accessory left posterior cerebral artery: a case report and clinical significance.

Deborah Boyett, Elias G Geist, Nadine M Khoury, Claire L Padilla, E Sander Connolly, Grace K Mandigo

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Article in Surgical and radiologic anatomy : SRA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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3 · Its place in the literature

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2 citing papers in PubMed.

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5 · Who and what money

Authors and funding

6 authors.

Deborah BoyettDepartment of Neurological Surgery, Columbia University Irving Medical Center, 710 W 168th Street, New York, NY, 10032, USA.
Elias G GeistDepartment of Neurological Surgery, Columbia University Irving Medical Center, 710 W 168th Street, New York, NY, 10032, USA.
Nadine M KhouryDepartment of Neurological Surgery, Columbia University Irving Medical Center, 710 W 168th Street, New York, NY, 10032, USA.
Claire L PadillaDepartment of Neurological Surgery, Columbia University Irving Medical Center, 710 W 168th Street, New York, NY, 10032, USA.
E Sander ConnollyDepartment of Neurological Surgery, Columbia University Irving Medical Center, 710 W 168th Street, New York, NY, 10032, USA.
Grace K MandigoDepartment of Neurological Surgery, Columbia University Irving Medical Center, 710 W 168th Street, New York, NY, 10032, USA. ghk9@cumc.columbia.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAnatomic variants of the posterior cerebral circulation pose important clinical implications and are essential to understand during the preparation and execution of various endovascular, cranial, and thoracic procedures.

methodsWe discuss the case of a 54-year-old woman presenting with subarachnoid hemorrhage and found to have a left vertebral artery originating from the descending thoracic aorta at the level of T5 and accessory, "true fetal" posterior cerebral artery on Digital Subtraction Angiography (DSA).

resultsWhile the "fetal" posterior cerebral artery (PCA) variant is relatively common, the "true fetal" PCA involves persistence of the primitive anterior choroidal artery into adulthood, despite the development of a second posterior circulation artery. In similar fashion, the aortic artery origin of the vertebral artery is well documented, but origin below the level of T4 is not observed in human or mammalian anatomy.

conclusionTo our knowledge, this is the first reported case of the vertebral artery originating from the descending aorta below the level of T4, and the only reported case with both variants present in the same patient, thus warranting further discussion of their embryologic origins and clinical ramifications.

Indexed as

Anatomic VariationAorta, ThoracicPosterior Cerebral ArteryVertebral ArteryAngiography, Digital SubtractionClinical RelevanceFemaleHumansMiddle AgedSubarachnoid HemorrhageAneurysmAngiographyDescending/thoracic aortaPosterior cerebral arteryTrue fetal PCA

Identifiers

PMID40615584

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