Discipline of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Westville Campus, Private Bag X54001, Durban, 4000, South Africa.
Department of Neurosurgery, School of Clinical Medicine, Nelson R Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
Neuroradiology. 2023 Dec;65(12):1677-1684. doi: 10.1007/s00234-023-03223-9. Epub 2023 Oct 25.
A recent meta-analysis on the incidence of iatrogenic injury to the VA has revealed that patients with variant anatomy are more prone to iatrogenic injury. Therefore, this review is designed to investigate the incidence of variations in the suboccipital component of the vertebral artery in different population groups according to the available literature.
This systematic review was conducted according to PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The review is based on a comprehensive and extensive search of PubMed, Google Scholar, and ResearchGate. The following search terms were used: "vertebral artery" AND "suboccipital segment" AND "anomalies/anatomical variations of the V3 segment." Reference lists of all extracted articles were also extensively searched for references to any further relevant publications.
A total of 17 papers met the inclusion criteria. The 17 studies corresponded to a total of 10,820 patients. A persistent first intersegmental artery was registered in 1.8% (197 out of 10,820) of the patients. Extradural PICA origin was observed in 1.6% (175 out of 10,820) of the patients. Fenestration was detected in 0.7% (72 out of 10,820) of the patients.
The authors summarize the incidence of vascular variation at the suboccipital segment of the VA in different population groups across the Asian, European, American, and African continents. Awareness of the extent of possible anatomical variation will help interpret radiographs, which will enhance the identification of vascular pathologies and reduce the risk of iatrogenic injury.
最近一项关于椎动脉医源性损伤发生率的荟萃分析显示，变异解剖结构的患者更容易发生医源性损伤。因此，本综述旨在根据现有文献调查不同人群人群下椎动脉枕骨下段的血管变异发生率。
本系统评价按照 PRISMA 指南（系统评价和荟萃分析的首选报告项目）进行。综述基于对 PubMed、Google Scholar 和 ResearchGate 的全面广泛搜索。使用了以下搜索词：“椎动脉”和“枕骨下段”和“V3 段的异常/解剖变异”。还广泛搜索了所有提取文章的参考文献列表，以查找任何进一步相关出版物的参考文献。
共有 17 篇文章符合纳入标准。这 17 项研究共涉及 10820 名患者。1.8%（197/10820）的患者存在持续的第一椎间段动脉。1.6%（175/10820）的患者存在硬膜外小脑后下动脉起源。0.7%（72/10820）的患者存在窗孔。
作者总结了亚洲、欧洲、美洲和非洲不同人群人群中椎动脉枕骨下段血管变异的发生率。了解可能的解剖变异程度将有助于解读影像学检查，这将有助于识别血管病变并降低医源性损伤的风险。
