Anomalous Origin of the Right Vertebral Artery

An anomalous origin of the right vertebral artery (VA) is a rare anomaly that is much rarer than that of the left VA. It can be divided into a few patterns, including aortic origin, right carotid or brachiocephalic arterial origin, and duplicated origin. In embryological development, the VA is made up of a longitudinal anastomosis between cervical segments. The mechanism of the anomalous origin of the right VA can be explained by the persistence of the cervical segmental artery and the regression point of the 4th right aortic arch. Although the anomaly is usually found incidentally on imaging modalities, it can be a potential cause of complication during surgical and interventional procedures. However, there are a lot of reports about the radiomics of the anomaly. Therefore, we discuss the potential relationship between the anomalous origin of the right VA and radiomics. As the take-home message, understanding several patterns of anomalous origin of the right VA with their embryology and imaging findings is important for surgical and endovascular interventions to avoid intraprocedural complications.