Surgicoanatomical aspect in vascular variations of the V3 segment of vertebral artery as a risk factor for C1 instrumentation

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dc.contributor.authorArslan, Dilek
dc.contributor.authorOzer, Mehmet Asim
dc.contributor.authorGovsa, Figen
dc.contributor.authorKitis, Omer
dc.date.accessioned2019-10-27T09:41:07Z
dc.date.available2019-10-27T09:41:07Z
dc.date.issued2019
dc.departmentEge Üniversitesien_US
dc.description.abstractObject: Awareness of vascular anomalies in V3 segment of vertebral artery (VA) is crucial to avoid iatrogenic injuries during surgical procedure. This study aimed to analyze the incidence of V3 segment vascular variations and demonstrate the importance of deciding the surgical strategy for C1 screw placement. Methods: Prevalence of vascular variations and morphometric measurements of the VA in the region of the craniocervical junction in 200 cases based on three-dimensional computed tomographic angiography (3D-CTA) scans were studied. Results: The VA has a variable course through C2 before it passes above its groove on the posterior arch of C1. Following the vascular variations of V3 segments of VA were persistent including first intersegmental artery (FIA), fenestration (FEN) of the VA, high-riding (HRVA and the posterior inferior cerebellar artery (PICA) branch originating from the C1/2 part of VA. HRVA was observed in 10.1% of patients, FIA in 1.8%, FEN in 1.3%, and PICA in 1.3%. One hundred and twenty-three (24.1%) patients were identified to have HRVA, 6% present on both sides. Conclusion: The VA with FIA and FEN were rare in this study as many as a 10% the VA present over the starting point for C1 lateral screw. With respect to the vascular anatomy of V3 and more frequent left-sided VA dominancy, standard screw insertion should be started from the right side. Routine preoperative 3D-CTA evaluation is mandatory to prevent the VA injury when C1-C2 instrumentation is planned. (C) 2019 Elsevier Ltd. All rights reserved.en_US
dc.identifier.doi10.1016/j.jocn.2019.07.032en_US
dc.identifier.endpage249en_US
dc.identifier.issn0967-5868
dc.identifier.issn1532-2653
dc.identifier.pmid31345535en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage243en_US
dc.identifier.urihttps://doi.org/10.1016/j.jocn.2019.07.032
dc.identifier.urihttps://hdl.handle.net/11454/28580
dc.identifier.volume68en_US
dc.identifier.wosWOS:000486093600040en_US
dc.identifier.wosqualityQ3en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherElsevier Sci Ltden_US
dc.relation.ispartofJournal of Clinical Neuroscienceen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectVertebral arteryen_US
dc.subjectV3 segmenten_US
dc.subjectHigh-riding vertebral arteryen_US
dc.subjectSurgical anatomyen_US
dc.subjectSafe zoneen_US
dc.subjectC1-C2 instrumentationen_US
dc.titleSurgicoanatomical aspect in vascular variations of the V3 segment of vertebral artery as a risk factor for C1 instrumentationen_US
dc.typeArticleen_US

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