MUSTAFA GÜVENÇER, A. Cenk ERDAL, Süleyman TETİK

Arteria vertebralis V1 segmentinin anatomik özellikleri ve cerrahi önemi

Amaç: Ekstrakraniyal arteria vertebralis'i (AV) etkileyen en sık patoloji aterosklerozdur. Arteria subclavia'daki (AS) AV'in orijin yeri, stenozun ve aterom plaklarının en sık görüldüğü yer olması nedeniyle önemlidir. Bu çalışmanın amacı AV'in VI segmentinin anatomik özelliklerini ve cerrahi önemini belirlemektir. Gereç ve yöntem: Formaldehit ile tespit edilmiş, 12 erkek kadavrada çalışılarak sağ-sol karşılaştırması, "Mantı Whitney U Testi" ile istatistiksel olarak değerlendirildi (p < 0,05). Bulgular: AV'in AS'dan orijin uzaklıkları sağ ve sol arasında anlamlı farklılık gösterir (p = 0,001). AV'in orijini ile truncus thyrocervicalis'in orijini arasındaki uzaklık, sağda ve solda ölçüldü ve genel ortalama 7,29 mm olarak bulundu (p = 0,157). Sol AV'lerin tüm servikal vertebra düzeylerinde sağ AV'lerden daha geniş olduğu ve orijininden Cö'ya doğru çıkıldıkça sağda ve solda az da olsa kademeli olarak çapın küçüldüğü gözlendi. Arteria thyroidea inferior'un (ATI), AV'yi çaprazladığı noktanın AV'nin orijinine uzaklığı, sağda 16,94 mm, solda 21,32 mm, genel ortalamada ise 19,02 mm olarak tespit edildi (p = 0,291). Sonuç: VI segmentinin, AS, ATI ve arteria carotis communis (ACQ ile uzaklıkları ve ilişkileri, yakın komşuluğunda bulunan truncus sympathicus, ganglion stellatum ve nervus phrenicus ile olan konumu önemlidir. Özellikle VI segmentinin büklümlü olduğu durumlarda, iatrojenik yaralanmaları engellemek için, AV'nin VI segmentine planlanan her türlü cerrahi girişim öncesi cerrahi alanın ayrıntılı olarak değerlendirilmesi gereklidir.

Anahtar Kelimeler:

Karotis arterleri, Anatomi, Kadavra, Vertebral arter

The anatomic properties and the surgical importance of the V1 segment of the vertebral artery

Objective: The most common pathology that affects the extracranial vertebral artery (VA) is atherosclerosis. The subclavian artery origination of the VA is important, as it is the place where the stenosis and the atherom are mostly seen. The aim of this study is to determine the anatomic properties and the surgical importance of the VI segment of the VA. Material and method: 12 corpses fixed with formaldehyde were studied. All measurements were done bilaterally and comparison of the right and the left were evaluated by using the Mann Whitney U Test (p < 0.05). Results: The distances between the origins of the VA and the subclavian artery were significantly different on the right and the left side (p = O.QOl). The distance between the origin of the VA and the truncus thyrocervicalis on the right side was approximately 6.51 i 2.76 mm, on the left side 8.08 + 2.69 mm,'mean value on both sides, was determined as 7.29 ± 2.78 mm (p = 0.157). The VAs on the left side werewider than the ones on the right side at all the levels of the cervical vertebrates and from the origins to the way toward C6, calibrations on both sides were decreasing gradually. The distance between the origin of the VA and the point that inferior thyroidea artery was crossing the VA was measured approximately as 16.94 i 6.62 mm on the right side, 21.32 ± 7.90 mm on the left side and the mean,was determined as 19.02 ± 7.41 mm. There was no significant difference between the right and the left sides (p = 0.291). Conclusions: The distance between the VI segment and the subclavian artery, the inferior thyroidea artery and the common carotid artery and its relations with them and its localization related to the near neighbors such as sympathic trunc, stellate ganglion and phrenic nerve are important. Espeecially, if there is tortuosity at the VI segment in order to prevent the iatrogenic injuries, diagnosis should be done properly before operation

Keywords:

Carotid Arteries, Anatomy, Cadaver, Vertebral Artery,

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