A comprehensive review of the vertebral artery anatomy

Background

The vertebral arteries (VA) play a critical role by supplying nearly one-third of the brain’s blood flow, predominantly contributing to the posterior circulation. These arteries may need to be exposed in a various cranial and cervical procedures and offers access to investigate or treat vascular lesions by endovascular means related to the posterior circulation. Given its complex anatomy, which is subject to numerous variations, and its role in supplying vital brain regions, a thorough understanding of the VA’s anatomy is paramount for any related procedure.

Objective

To provide a comprehensive overview of vertebral artery anatomy and its relevance in contemporary clinical practice.

Methods

Dissection of the entire vertebral artery length using cadaveric specimen, combined with a comprehensive literature review.

Results

The vertebral artery can be subdivided into four segments. Each of these segments has its own unique topographic anatomy with its variations, anastomoses, and significance in surgery.

Conclusion

As surgical and endovascular techniques continue to evolve with technological improvements, we are now more equipped than ever to manage complex lesions involving the VA. However, with its increasingly complexity comes the necessity for a deeper and more comprehensive understanding of the VA. Possessing the detailed knowledge of the VA is vital for the successful execution of any procedure involving it.