Left Vertebral Artery Arising from the Aortic Arch, an Incidental Finding During Imaging: A Case Report

The vertebral arteries normally originate from the subclavian arteries. These arteries ascend through the transverse foramina of the cervical vertebrae (typically entering at the C6 level) to supply the posterior circulation of the brain. Anatomical variations in vertebral artery origin are uncommon.
Case report: A rare anatomic variation of the aortic arch was identified in a 63-year-old male during an evaluation of a vascular pathology with computed tomography angiography (CTA). The CTA demonstrated the left vertebral artery (LVA) arising directly from the aortic arch instead of originating from the left subclavian artery. The patient had no symptoms attributable to this vertebral artery anomaly, and no intervention was performed. This case report highlights the importance of recognizing a left vertebral artery arising from the arch for surgical or endovascular planning. This case report describes the abnormal LVA and discusses the embryological basis, imaging findings, and clinical implications of this anomaly.