A rare case of coexisting vascular anomalies and developmental variant of the brachiocephalic vessels

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Abstract

This article presents a rare case of coexisting vascular anomalies and developmental variants of the brachiocephalic vessels in a female patient who reported headaches triggered by food intake. The anomalies included: arteria lusoria, an aberrant right subclavian artery arising directly from the aortic arch and passing posterior to the esophagus; origin of the right vertebral artery from the right common carotid artery; origin of the left vertebral artery from the aortic arch; high vertebral artery entry points with hypoplasia; and excessive S-shaped tortuosity of the left internal carotid artery. This case is of particular interest due to the exceptional rarity of coexisting vascular anomalies and developmental variants in a single patient, qualifying it as a clinical curiosity. Variations in the origin and course of aortic arch branches may lead to altered cerebral hemodynamics and be associated with cerebrovascular disorders or neurological symptoms. Identifying atypical courses of the brachiocephalic vessels is crucial during preoperative assessment, as anomalous vascular anatomy may result in serious complications during surgical or endovascular interventions.

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About the authors

Roman K. Ayubov

Izhevsk State Medical Academy

Author for correspondence.
Email: ayubov.roman@gmail.com
ORCID iD: 0009-0000-1993-3124
SPIN-code: 2724-8400

student

Russian Federation, 2 Nizhnyaya st, Izhevsk

Aleksey A. Yakovlev

Izhevsk State Medical Academy

Email: al-an.iakowlew@yandex.ru
ORCID iD: 0000-0002-1987-2138
SPIN-code: 1764-4447

PhD Stud., assist., Depart. of Histology, embryology and cytology

Russian Federation, 2 Nizhnyaya st, Izhevsk

Mikhail V. Dudarev

Izhevsk State Medical Academy

Email: flatly@yandex.ru
ORCID iD: 0000-0003-2508-7141
SPIN-code: 4125-1073

MD, Dr. Sci. (Med.), Prof., Head of Depart., Depart. of the Polyclinic therapy with courses in clinical pharmacology and preventive medicine FPK and PP

Russian Federation, 2 Nizhnyaya st, Izhevsk

Gulnara E. Aidarova

Izhevsk State Medical Academy

Email: gylnaraaydarova@icloud.com
ORCID iD: 0000-0001-8034-5073
SPIN-code: 4083-7310

student

Russian Federation, 2 Nizhnyaya st, Izhevsk

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Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Three-dimensional angiography image of the brachiocephalic arteries: 1 — right common carotid artery (CCA); 2 — left CCA; 3 — left vertebral artery (VA); 4 — left subclavian artery (SA); 5 — right SA; 6 — right VA; 7 — entry of the left VA into the transverse foramina of the cervical vertebrae at the CIV level; 8 — tortuosity of the internal carotid artery; 9 — entry of the right VA into the transverse foramina of the cervical vertebrae at the level of CV.

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3. Fig. 2. Angiography of the brachiocephalic arteries in axial projection. The course of the right communicating artery behind the esophagus.

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4. Fig. 3. Angiography of the brachiocephalic arteries in sagittal projection. The origin of the left vertebral artery from the aortic arch with its high entry into the transverse foramina of the cervical vertebrae at the level of CIV: 1 — left common carotid artery; 2 — left vertebral artery; 3 — left subclavian artery.

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