PMC4971152_01
Baseline MDCT examination. (a) Axial source image, (b, c) Volume Rendering and (d) Curved Planar views show patent KD (*) associated with thrombosed prevertebral right lusory artery (RLA), autonomous origin of the left vertebral artery (LVA) from the aortic arch, and origin of both common carotid arteries from a short common trunk (CT). The proximal portion of the right vertebral artery (RVA) is patent, as well as the RLA distal to it. LSA = left subclavian artery.
gr1.jpg
PMC4971152_01_gr1.jpg
fig0005
An aberrant (lusory) right subclavian artery stemmed from the KD and was completely thrombosed at its origin as well (Fig. 1).
Two-month follow-up MDCT examination. (a) Axial source image, (b) Volume Rendering and (c) Curved Planar views show complete thrombosis of the KD extending from the prevertebral RLA. As at baseline, the proximal portion of the RVA and the RLA distal to it are patent.
gr2.jpg
PMC4971152_01_gr2.jpg
fig0010
The right vertebral artery was patent as well as the post-vertebral portion of the ipsilateral subclavian artery, suggesting retrograde vertebral flow due to subclavian steal phenomenon (Fig. 2).
Doppler ultrasound examination obtained with a transoccipital approach shows reversed flow in the RVA compared with the LVA.
gr3.jpg
PMC4971152_01_gr3.jpg
fig0015
A Doppler ultrasound examination was performed some days later for hemodynamic assessment, confirming reverse flow in the right vertebral artery compared with the left side (Fig. 3).