The anatomy and clinical importance of the collateral circles between the vertebral arteries and the cervical, costo-cervical, and occipital branches in 52 living subjects.
In this study, 52 cases of vertebral artery obstruction, comprising 29 women and 23 men between the ages of 27 and 78 years, were taken into consideration. The relevant arterial territories of these patients, who had sought medical attention for a variety of symptoms, were studied by means of doppler ultrasound, duplex, and digital subtraction angiography. Of the original 52 patients, 38 were excluded because of the failure to demonstrate a functional collateral circle with the vertebral artery distal to the point of its obstruction. Of the 14 remaining patients (6 men, 8 women), a collateral circle through cervical branches arising from the thyrocervical and costo-cervical trunks was demonstrable in 7. Six others (3 men, 3 women) demonstrated a collateral circle through a combination of cervical and occipital artery branches. In one (female) case, a collateral circle was demonstrated through the sole occipital artery. With the exception of a single case (a 47-year-old woman), the occlusion was localized to the origin of the vertebral artery. Hemodynamically, the collateral circles were sufficient to maintain perfusion.
Macchi
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Dipartimento di Anatomia Umana Normale ed Istolgia Policlinico di Careggi, Firenze.
Catini
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D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D003097:Collateral Circulation / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow; D013575:Syncope / Q000209:etiology; D014463:Ultrasonography; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D014717:Vertigo / Q000209:etiology; D014786:Vision Disorders / Q000209:etiology