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The tortuosity index (TI) was computed as the centreline-to-straight-line length ratio; VA dominance was determined at two segmental levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Left V1 was more tortuous than right (TI 1.37\u2009\u00b1\u20090.26 vs. 1.20\u2009\u00b1\u20090.15; Wilcoxon\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001; d_z\u2009=\u20090.74) in 82% of patients. TI correlated with age (Spearman \u03c1\u2009=\u20090.599,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001 for left; \u03c1\u2009=\u20090.439,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001 for right) but not with sex, and showed no association with calibre-based dominance (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.53). A more cranial VA origin was associated with higher TI (Spearman \u03c1 = \u22120.64,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001 for left; \u03c1 = \u22120.37,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009 for right) and remained a significant predictor in multivariable linear regression adjusted for age and sex (left V1 \u03b2 = \u22120.0408 per ordinal step toward a more caudal origin, 95% CI\u2009\u2212\u20090.0683 to \u2212\u20090.0133,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005) against a conserved bilateral C6 transverse-foraminal entry (76%). We refer to this configuration as the origin\u2013entry mismatch.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Left-sided V1 tortuosity was associated with an origin\u2013entry geometric mismatch; no association with calibre-defined dominance was detected.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00234-026-04180-9","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:11:05Z","timestamp":1788415865000},"page":"2587-2600","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Origin\u2013entry geometry and left-sided V1 vertebral artery tortuosity: a retrospective cross-sectional CT angiography study"],"prefix":"10.1007","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-4655-4574","authenticated-orcid":false,"given":"R\u0103zvan Costin","family":"Tudose","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodica Narcisa","family":"Calot\u0103","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8723-0540","authenticated-orcid":false,"given":"Mugurel Constantin","family":"Rusu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"4180_CR1","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1177\/17085381221140163","volume":"32","author":"F Aghasadeghi","year":"2024","unstructured":"Aghasadeghi F, Dehghan A (2024) Evaluation of the association between the internal carotid artery and vertebral artery tortuosity and acute ischemic stroke using tortuosity index. 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