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The occipital-vertebral anastomosis revisited
Affiliations- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
- Department of Anatomy, Medical University of Warsaw, Poland
- Department of Radiology, Jagiellonian University Medical College, Krakow, Poland
- Department of Anatomy, All India Institute of Medical Sciences, Patna, India
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Abstract
Background: The goal of the study was to provide relevant data about the location
and prevalence of the occipital artery-vertebral artery (OA-VA) anastomosis
in patients without visible occlusive disease, as well as to thoroughly discuss the
clinical significance of these anastomotic channels. Furthermore, the morphometric
properties of the OA and its branches were also analysed.
Materials and methods: A retrospective study was carried out to indicate
anatomical variations, their prevalence, and morphometrical data on the OA
and its branches. The study was performed on 55 randomly selected computed
tomography angiographies (CTA) of the head and neck region. Each CTA result
was analysed bilaterally. Thus, 110 results were originally assessed.
Results: The OA median maximal diameter was demonstrated at 4.85 mm
(lower quartile [LQ]: 4.11; upper quartile [UQ]: 5.53) and the median maximal
diameter of VA at 3.60 mm (LQ: 2.79; UQ: 4.38). The distances between OA
and its branches were also measured giving a median result of 21.73, 30.29,
60.84, 34.88, 18.02, 55.16 mm for the lower and upper sternocleidomastoid
branch, meningeal branch, mastoid branch, and descending branch, respectively.
The median distance between OA and its first anastomosis was set to be
51.15 mm (LQ: 37.20; UQ: 60.10). Moreover, a set of additional measurements
was carried out in order to create a three-dimensional anatomical heat-map of
the occurrence of the OA-VA anastomosis.
Conclusions: Knowledge about the anatomy of the OA-VA anastomosis might
be of immense importance to avoid potentially fatal complications during embolisation
of the OA and its branches.
Abstract
Background: The goal of the study was to provide relevant data about the location
and prevalence of the occipital artery-vertebral artery (OA-VA) anastomosis
in patients without visible occlusive disease, as well as to thoroughly discuss the
clinical significance of these anastomotic channels. Furthermore, the morphometric
properties of the OA and its branches were also analysed.
Materials and methods: A retrospective study was carried out to indicate
anatomical variations, their prevalence, and morphometrical data on the OA
and its branches. The study was performed on 55 randomly selected computed
tomography angiographies (CTA) of the head and neck region. Each CTA result
was analysed bilaterally. Thus, 110 results were originally assessed.
Results: The OA median maximal diameter was demonstrated at 4.85 mm
(lower quartile [LQ]: 4.11; upper quartile [UQ]: 5.53) and the median maximal
diameter of VA at 3.60 mm (LQ: 2.79; UQ: 4.38). The distances between OA
and its branches were also measured giving a median result of 21.73, 30.29,
60.84, 34.88, 18.02, 55.16 mm for the lower and upper sternocleidomastoid
branch, meningeal branch, mastoid branch, and descending branch, respectively.
The median distance between OA and its first anastomosis was set to be
51.15 mm (LQ: 37.20; UQ: 60.10). Moreover, a set of additional measurements
was carried out in order to create a three-dimensional anatomical heat-map of
the occurrence of the OA-VA anastomosis.
Conclusions: Knowledge about the anatomy of the OA-VA anastomosis might
be of immense importance to avoid potentially fatal complications during embolisation
of the OA and its branches.
Keywords
occipital artery, anastomosis, anatomy, vertebral artery
About this articleTitle
The occipital-vertebral anastomosis revisited
Journal
Issue
Article type
Original article
Pages
615-623
Published online
2022-11-30
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955
Article views/downloads
633
DOI
Pubmed
Bibliographic record
Folia Morphol 2023;82(3):615-623.
Keywords
occipital artery
anastomosis
anatomy
vertebral artery
Authors
P. Ostrowski
M. Bonczar
Alicia del Carmen Yika
H. Czekańska
J. Batko
W. Wojciechowski
S. K. Ghosh
J. Jaworek-Troć
K. Piątek-Koziej
A. Juszczak
T. Gładysz
D. Lusina
J. Walocha
M. Koziej
References (19)- Akeel M. Myomucosal island flap of the buccinator muscle: an anatomical study. Transl Res Anat. 2021; 22: 100091.
- Alvernia JE, Fraser K, Lanzino G. The occipital artery: a microanatomical study. Neurosurgery. 2006; 58(1 Suppl): ONS114–22; discussion ONS114.
- Benet A, Tabani H, Ding X, et al. The transperiosteal "inside-out" occipital artery harvesting technique. J Neurosurg. 2018; 130(1): 207–212.
- Bonczar M, Gabryszuk K, Ostrowski P, et al. The thoracoacromial trunk: a detailed analysis. Surg Radiol Anat. 2022; 44(10): 1329–1338.
- Bonczar M, Ostrowski P, Dziedzic M, et al. The costocervical trunk: A detailed review. Clin Anat. 2022; 35(8): 1130–1137.
- Carvey M, Yang G, Hage R. Skin flaps: a novel approach to medical student instruction on integumentary arterial blood supply. Transl Res Anat. 2021; 23: 100104.
- Di G, Fang X, Hu Q, et al. A microanatomical study of the far lateral approach. World Neurosurg. 2019; 127: e932–e942.
- Kawashima M, Rhoton AL, Tanriover N, et al. Microsurgical anatomy of cerebral revascularization. Part II: posterior circulation. J Neurosurg. 2005; 102(1): 132–147.
- Macchi C, Catini C. 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. Ital J Anat Embryol. 1993; 98(3): 153–163.
- de Magalhães RP, Ferraz AR, Brandão LG, et al. Osteogaleal pedicle flap of the occipital region for head and neck reconstruction: anatomic study. J Otolaryngol. 1998; 27(4): 195–199.
- Milnerowicz M, Garcarek J, Bladowska J, et al. Bilateral thalamic stroke after tonsillectomy in a patient with collateral extracranial anastomosis - case report. Pol J Radiol. 2019; 84: e126–e130.
- Moore KL, Dalley AF, Agur A. Clinically oriented anatomy. 8th ed. Lippincott Williams and Wilkins 2017.
- Ostrowski P, Bonczar M, Plutecki D, et al. The occipital artery: a meta-analysis of its anatomy with clinical correlations. Anat Sci Int. 2023; 98(1): 12–21.
- Ostrowski P, Bonczar M, Shafarenko K, et al. The thyrocervical trunk: an analysis of its morphology and variations. Anat Sci Int. 2023; 98(2): 240–248.
- Reinisch JF, van Hövell Tot Westerflier CV, Tahiri Y, et al. The occipital artery-based fascial flap for ear reconstruction. Plast Reconstr Surg. 2019; 143(3): 592e–601e.
- Schechter MM. The occipital-vertebral anastomosis. J Neurosurg. 1964; 21: 758–762.
- Spetzler RF, Modic M, Bonstelle C. Spontaneous opening of large occipital-vertebral artery anastomosis during embolization. Case report. J Neurosurg. 1980; 53(6): 849–850.
- Takeuchi Y, Numata T, Konno A, et al. Hemodynamic changes in the head and neck after ligation of the unilateral carotid arteries: a study using color Doppler imaging. Ann Otol Rhinol Laryngol. 1994; 103(1): 41–45.
- Tenna S, Brunetti B, Aveta A, et al. Scalp reconstruction with superficial temporal artery island flap: clinical experience on 30 consecutive cases. J Plast Reconstr Aesthet Surg. 2013; 66(5): 660–666.
