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There were no fenestrated nor first intersegmental arteries in our cohort. No systematic differences were detected between SKD and control patients with respect to vertebral artery anatomy. Nonetheless, surgically relevant variability was observed in both groups. Paying particular attention to the direction of exit at C3 and curvature at C2 with respect to the foramen and vessel dominance are important and easily classifiable abnormalities that both surgeons and radiologists can use to communicate and employ in pre-operative planning. III.