Aortic arch variation: A unique case with anomalous origin of both vertebral arteries as additional branches of the aortic arch distal to left subclavian artery

We present the case of bilateral anomalous origin of both vertebral arteries (VAs) in a 20-year-old male patient who presented for routine contrast-enhanced CT follow-up examination of the chest. Contrast-enhanced CT revealed abnormal origins of both the VAs from the aortic arch distal to the origin of the left subclavian artery. Following this, CT angiography was performed, which confirmed the findings. To our knowledge, this is the first report of anomalous origins of both VAs beyond the origin of the left subclavian artery. The possible embryonic mechanism and the clinical importance of this variant is also reviewed.