Abstract Details

Title Anomalous Right Vertebral Artery Origin from the Right Common Carotid Artery: A Rare Angiographic Finding

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P14 - Poster Session 14 (11:45 AM-12:45 PM)

Poster/Presentation
Number 13-010

Objective To report a case of incidental finding of aberrant origin of right vertebral artery from the right common carotid artery (CCA) on CT angiography

Background Anomalous origin of the right vertebral artery (VA) from the right CCA is very rare and is invariably associated with an aberrant right subclavian artery (RSCA), which is usually clinically asymptomatic and found incidentally during angiographic imaging. The incidence of anomalous origin of the right VA from the right CCA is 0.18%, whereas the incidence of aberrant RSCA is 1.5%. This incidental imaging finding is of significant diagnostic importance during the preoperative vascular surgery planning in the neck and for road mapping endovascular approaches to cervical/intracranial pathology, thus preventing any iatrogenic risk of ischemic injury to the anterior/posterior cerebral circulations. Here, we present one similar case

Design/Methods Case report

Results 54-year-old woman with hyperlipidemia, pre-diabetes, taking preadmission daily aspirin for primary prevention of cardiovascular events, admitted for workup of acute right central retinal artery occlusion (CRAO), manifested by sudden-onset painless right monocular vision loss due to atherosclerotic disease and aspirin failure, with NIHSS 1, preadmission mRS 0. No IV thrombolysis or thrombectomy was done as the patient was out of the intervention window. Eye exam remarkable for right monocular central vision loss (sparing periphery) and fundoscopy showing right cherry-red spot and optic disc pallor. CTA head and neck showed aberrant right VA origin from the right CCA, with no stenosis and atheromatous plaque at origin of right ophthalmic artery. LDL 124, HgbA1c 6%. Transthoracic echo, telemetry and EKG within normal limits. She was discharged home taking dual antiplatelet therapy for 3 weeks, followed by clopidogrel continuation lifelong, and atorvastatin

Conclusions

Vertebral artery anomalies, mainly on the right side, are rare and discovered incidentally during angiographic imaging. Their identification is of extreme diagnostic importance during preoperative surgical and endovascular planning.

Authors/Disclosures
Sara Habib, MD (IU Health Arnett Neurology) PRESENTER	Dr. Habib has nothing to disclose.
Ahmer Asif, MD	Dr. Asif has nothing to disclose.
Maria Shoaib, MD (Peace Health Southwest)	Dr. Shoaib has nothing to disclose.
Sameera Siddiqui, MD (OUHSC)	Dr. Siddiqui has nothing to disclose.
Robert Hamilton, MD (Mercy)	Dr. Hamilton has nothing to disclose.

��ɫ��

��ɫ��