Straight Angiographic Projections of Vertebral Artery

Vertebral Artery Angiographic Projections

Straight Antero-Posterior View:
• Why this projection? Basilar artery lies on the clivus. This gives basilar artery a caudal angulation.
• How to set? Therefore, to resolve this angle and have the basilar artery well-visualized, the A-plane should take a slight caudal projection. A caudal projection of A-plane brings the petrosal ridge into the lower half of the orbit. C2 vertebrae should also be included, to bring the third segment of vertebral artery into the frame. Occasionally contralateral vertebral artery is retrogradely visualized, an acceptable alternative to contralateral vertebral artery injection.
• What does it visualize? Antero-posterior view in vertebro-basilar angiograms is also suitable to visualize the third and forth segments of vertebral artery, basilar artery and its branches, proximal posterior cerebral arteries and the lateral venous sinuses.


Straight Lateral View:
• How to set? To set straight lateral view, pick a bilateral bone landmark, such as external auditory meati or frontal tables, and by moving the B-plane make those landmarks overlap. Also include C1-C2 in your projection to bring the 3rd and 4th segments of vertebral artery into the frame.
• What does it visualize? Straight lateral view of vertebro-basilar angiogram is suitable to visualize the third and forth segments of the vertebral artery, basilar artery, mid- and distal posterior cerebral arteries, and the following venous structures: internal cerebral vein, basal vein of Rosenthal, vein of Galen and straight sinus.

Music Credit: Leonell Cassio - The Blackest Bouquet


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