21 - Bilateral Origin of the Vertebral Arteries in the Aortic Arch

Poster Board Number: 21
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Co-authors:

Carlos Eduardo de Carvalho - Universidade do Estado do Amazonas; Edinaldo Junior - Universidade do Estado do Amazonas; Amanda Beatriz Pedreno Da Silva - UEA; Rafaela Cardoso De Souza - UEA; Fernando Luiz Westphal - UFAM; Carlos Reinaldo Ribeiro Da Costa - UEA; Gabriel de Andrade Bezerra - UEA; Symonne Araújo Gomes - UNL; Menderson Augusto Gadelha Cavalcante - UNL; Maria Elania Brás Barros - UNL; Marília Gabriela de Carvalho Alves - UNL; Maria Eduarda Castro Aguiar Gomes De Lima - UNL; Laura Cid Vieira Belém - UNL; Sandoval Fernando Cardoso de Freitas Junior - UNL; Marcio Ney Gonçalves Negreiros - UNL; Yasmin Victoria Loureiro Alvares de Oliveira Sosa Diaz - UNL; André Maia Lopes - UNL; Raimundo Nonato Fernandes Junior - UNL; Ana Luiza Pereira De Aguiar - UNL; Letícia Pinto Gondim Medeiros - UNL; Fernanda Possimoser Santos - UNL; Sara Regina Moura de Freitas - UNL; Paulo Rodrigues dos Santos Júnior - UNL; Renata Rodrigues Gama - UNL; Adenei da Silva Xavier - UNL; Thiago Soares Martins - UEA; Paulo Victor Mourão Machado - UNL; Giberto Santos Cerqueira - UFC

Abstract Body :
Introduction. Vertebral arteries most often originate from the initial portion of the subclavian arteries. These vessels have a classic ascending trajectory, through the transverse foramina of the first six cervical vertebrae, finally entering the cranial cavity through the foramen magnum (Gardner; Gray; O' Rahilly, 1988). There is a diversity of possible origins, including the carotid arteries, dual origins generally arising from the subclavians or the aortic arch. Furthermore, there are multiple possibilities, albeit at low percentages, such as bilateral origin of the vertebral arteries, which have an infinite probability of occurring below 0.1% (Lazaridis et al., 2018). Case details. During the dissection of an adult cadaver at the Human Anatomy Laboratory of the State University of Amazonas, it was possible to observe an anatomical variation in the place of origin of the right and left vertebral arteries, emerging in parallel between the brachiocephalic trunk and the left common carotid artery, directly from the arch of the aorta. Discussion. The vertebral arteries generally develop between 33 and 55 days during intrauterine life, and are normally constituted by the longitudinal anastomoses that connect the seven cervical intersegmental arteries. In addition to developmental failures, deletion of chromosome 22q11 has been reported to be associated with aortic arch anomalies (MOMMA et al., 1999). Considering studies on the origin of the vertebral arteries, it is highlighted that, although the left vertebral artery has approximately 15% chance of originating directly from the aortic arch (Einstein et al., 2016), the percentage of chance of the right vertebral artery is originating directly from the aortic arch is more remote, being approximately 0.7% (Lazaridis et al., 2018). Conclusion. The direct origin of the vertebral arteries from the aortic arch can cause changes in the hemodynamics of the circulation due to increased blood flow. Understanding the possibilities of variations, even those with a remote probability of occurring, is essential to offering safer treatment. Thus highlighting the importance of complete medical training that addresses the diversity of anatomical variations, in addition to the findings of this study having the potential to enrich the understanding of this synergistic universe between anatomy and clinical practice, an association capable of preserving lives.