Features of the Variant Anatomy of the Vertebral Artery in the Third Segment
Introduction. One of the most common forms of cerebrovascular pathology is the vertebrobasilar insufficiency (VBI). This is a dysfunction of the brain caused by the decrease of the blood supply to the vascularization zone of the vertebral and basilar arteries. The study of the vertebral arteries (VA) was carried out on the sectional material. The angioarchitectonics of the vessels was studied, taking into account individual differences. Surgical access to VA in the third segment was developed to avoid high risks of damage to the artery wall and intraoperative bleeding.Purpose. To study the congenital structural features of the vertebral and main arteries. Materials and methods. The study of the vertebral arteries was carried out on sectional material with the description of anatomical differences. The length of the vertebral arteries and the distance between the transverse processes C1-C2 and C1 - the edge of the occipital foramen (OF), the outer diameter of the VA, the diameter of the OF, and the ratio of its size to the diameter of the vessels were measured. The features of PA“fixation” at the expense of the spinal branch in the C1-C2 interval and the development of the safest surgical approach in the segment 3 were studied. Results. 1. Posterior spinal branches were identified in the interval between C1 and C2 in 20% of cases, with all branches extending from the posterior surface of the VA, following medially to the spinal canal. 2. The length of the artery in the C1-C2 interval is 16.4 mm, which is the most optimal place for anastomosis without resection of the Atlant. 3. The C1-C2 segment is more preferable for the formation of the anastomosis, in comparison with the C1-edge of the OF segment, due to the greater thickness of the media and adventitia, which plays an important role in surgical treatment. Conclusion. The obtained results let to develop the safest surgical approach.