Anatomy and variations of the basilar artery examined with digital subtraction angiography

Abstract

Introduction: The basilar artery is formed by the union of the vertebral arteries; it runs over the ventral surface of the pons and terminates at the upper border of the pons by dividing into the posterior cerebral arteries. It gives of many vital branches supplying various parts of the brain. The aim of this study was to determine origin and variations of branches of the basilar artery with DS angiography. Materials and methods: We examined radiographs of 55 patients who had DS angiography undertaken for a variety of clinical reasons, performed as a part of their medical treatment at the University Clinic for Radiology in Skopje. The study population included 27 male and 28 females, age range from 18-79, mean age 51.09 years. Results: The AICA originated from the proximal half of the basilar artery in all patients. Most of the SCA arise from the basilar artery as a single vessel (92.7% on right and 94.5% on left). The most common variations of the SCA were duplication (frequency 3.63% on right and 1.81% on left) and origin from PCA (frequency 3.63% bilateral). The PCA was evaluated in all cases. The adult configuration was present in 74.54% of the patients; fetal configuration was present in 20% of the patients and transitional configuration was present in 5.45% of the patients on the left side. On the right side adult configuration was present in 83.63% of the patients; fetal configuration was present in 14.54% of the patients and transitional configuration was present in 1.81% of the patients. Conclusion: A precise understanding of the basilar artery anatomy is fundamental for planning and performing endovascular procedures and neuro-interventions, as well as for the accurate interpretation of ischemic areas.