Diagnosis of vertebral basilar artery variation with digital subtraction angiography

Objective This study is to investigate the prevalence of vertebral basilar artery veriation and its imaging characters in patients receiving cerebral artery digital subtraction angiography.Methods We reviewed 6432 patients receiving cerebral artery digital subtraction angiography,and got the prevalence of vertebral basilar artery veriation and associated cerebral artery diseases in these patients.Results Among the 6432 patients,4.2%(278vertebral arteries in 272cases)was diagnosed with anomalous origin of vertebral artery,including 4.2%of anomalous origin of the left vertebral artery(n=270,of which 258 vertebral arteries originated from the aortic arch,2cases were duplicitous origin of the left vertebral artery,4cases of vertebral artery originated from left internal carotid artery and 6vertebral arteries originated from the root of left subclavian artery)and 8were anomalous origin of the right vertebral artery(of which 2branches originated from right common carotid artery,2originated from right internal artery,2duplicitous origin of the right vertebral artery,2originated from brachiocephalic trunk).61 branches of PCA originated from infraversion.The fenestrations of vertebral basilar artery were 141cases(2.19%).Persistent trigeminal artery were 11cases(0.17%).Among the fenestrations of cerebral artery,9cases were accompanied with aneurysms,2cases were accompanied with arteriovenous malformation.7cases were accompanied with cerebral ischemia,2cases accompanied with cerebral infarction.1case of duplicitous origin of the right vertebral artery was accompanied with cerebral infarction.Conclusion Cerebral artery digital subtraction angiography was able to show the location,morphology,adjacent relationship and associated vascular diseases in vertebral basilar artery fenestration.This could provide more information for the diagnosis and treatment of cerebrovascular diseases,especially for the neuroradiology intervention therapy.