Vujmilović S, Spasojević G, Vujnović S, Malobabić S, Vujković Z
University of Banja Luka, Faculty of Banja luka , Department of Anatomy, Save Mrkalja 14, 78000 Banja Luka, Bosnia and Herzegovina.
Folia Morphol (Warsz). 2018;77(4):687-692. doi: 10.5603/FM.a2018.0036. Epub 2018 Apr 13.
Vertebral artery (VA), the main element of the posterior brain circulation, has many anatomical variations which generally were widely investigated. However, available data vary in wide ranges, reflecting very different sample sizes, lack of data about left-right or sex differences, and about possible ethnic, regionally specific or genetic differences.
Certain new findings suggest possible involvement of some environmental factors in VA variations. Accurate anatomical data about VA variations in different regions of the world, including Balkans countries, are still lacking. Therefore we investigated morphological variability of VA origin and its entrance level into cervical transverse foramina in population of Republika Srpska (Bosnia and Herzegovina), including data about the sex and side.
Anatomy of VA was investigated in 112 persons (224 arteries) of both sexes (58 males, 54 females; age 19-83 years), using 64-slice computed tomography (CT) scanner. Origin of VA from subclavian artery (SCA) we found in 95.08% of arteries (52 males, 49 females). Only in 1 (0.45%) male left VA and left SCA had an specific origin from aortic arch (AA), which we named as an "common area of origin". All other observed variations in origin were only of left VA, originating from AA in 4.47% (5 males, 5 females). Left VA most often (usual) entrance level into transverse foramen we found at C6 (87.5%), followed by C5 (8.93%), C4 (3.12%), and in 1 case at level C7 (0.45%). Entry levels at C5, both on right and on the left side, were three times more frequent in males than in females.
Wide ranges of differences between the data we obtained on a sample in Republika Srpska (Bosnia and Herzegovina) and the data from many other studies require further and wider investigations.
椎动脉（VA）是后脑循环的主要组成部分，有许多解剖变异，对此已进行了广泛研究。然而，现有数据差异很大，反映出样本量差异极大、缺乏关于左右差异或性别差异的数据，以及关于可能的种族、地区特异性或基因差异的数据。
某些新发现表明一些环境因素可能与椎动脉变异有关。目前仍缺乏关于世界不同地区（包括巴尔干国家）椎动脉变异的准确解剖数据。因此，我们对波斯尼亚和黑塞哥维那斯普斯卡共和国人群的椎动脉起源及其进入颈椎横突孔的水平的形态变异性进行了研究，包括性别和左右侧的数据。
使用64层计算机断层扫描（CT）扫描仪对112人（224条动脉）进行了椎动脉解剖研究，其中男性58人，女性54人，年龄在19至83岁之间。我们发现95.08%的动脉（52名男性，49名女性）的椎动脉起源于锁骨下动脉（SCA）。仅1名（0.45%）男性的左椎动脉和左锁骨下动脉起源于主动脉弓（AA）的一个特定区域，我们将其命名为“共同起源区域”。所有其他观察到的起源变异仅发生在左椎动脉，4.47%（5名男性，5名女性）起源于主动脉弓。我们发现左椎动脉最常（通常）进入横突孔的水平在C6（87.5%），其次是C5（8.93%）、C4（3.12%），1例在C7水平（0.45%）。C5水平的进入，无论右侧还是左侧，男性的频率均是女性的三倍。
我们在波斯尼亚和黑塞哥维那斯普斯卡共和国的样本中获得的数据与许多其他研究的数据之间存在广泛差异，这需要进一步更广泛的研究。
