title: Anomalous Right Vertebral Artery Originating from the Aortic Arch Distal to the Left Subclavian Artery: A Case Report and Review of the Literature.
abstract: OBJECTIVE
  Present a case report of an anomalous origin of the right vertebral artery originating from the aortic arch distal to the left subclavian along with a review of cases reported to date in the literature.
  
  
  METHODS
  Provide background information on this rare anomaly, present the case report, review the literature using PubMed, summarize previously reported cases to date, and discuss the underlying embryologic development of this anomaly along with its significance.
  
  
  RESULTS
  We report a 54-year-old man presenting with a subarachnoid hemorrhage referred for diagnostic cerebral arteriography who was found to have an anomalous origin of the right vertebral artery originating from the aortic arch distal to the left subclavian artery in conjunction with a bovine arch. We also report 13 previously reported cases along with their other associated variant anatomy.
  
  
  CONCLUSIONS
  Based upon our present case and previously documented cases to date, this anomaly is a rare finding. An understanding of aberrant anatomy and its embryologic basis is paramount to avoiding inadvertent vascular injury during diagnostic cerebral angiography. Therefore, this abnormality must be considered if selective vertebral artery catheterization is difficult or unsuccessful.
authors: Department of Neurosurgery and Interventional Radiology, University of Colorado, CO, USA.
authors: David
authors: D
authors: Case
authors: Department of Neurosurgery and Interventional Radiology, University of Colorado, CO, USA.
authors: Joshua
authors: J
authors: Seinfeld
authors: Department of Neurosurgery and Interventional Radiology, University of Colorado, CO, USA.
authors: Zach
authors: Z
authors: Folzenlogen
authors: Department of Neurosurgery and Interventional Radiology, University of Colorado, CO, USA.
authors: David
authors: D
authors: Kumpe