Clinical Importance of the Persistent Primitive Trigeminal Artery in Vascular Lesions and Its Role in Endovascular Treatment

Abstract

The persistent primitive trigeminal artery (PPTA) extends from the internal carotid artery to the basilar artery between the origins of the anterior inferior cerebellar artery and superior cerebellar artery. PPTAs have complex anatomical characteristics. Salas and Saltzman classifications are most often used in PPTAs. The PPTA can play many roles in vascular lesions, including intracranial aneurysms, brain arteriovenous malformations, trigeminal artery-cavernous fistulas, Moyamoya disease, and large vessel occlusion. For these lesions, surgical treatment is difficult due to the deep location and complex anatomy of the PPTA, but endovascular treatment (EVT) has emerged as a good alternative. Currently, a complete review of the clinical importance of the PPTA in terms of its role in the development and EVT of vascular lesions is lacking. Therefore, we conducted a PubMed search, performed a review of the relevant extracted literature and cataloged our experience with PPTAs. By review, we found that a thorough understanding of the anatomical and angiographic features of this PPTA is of utmost importance when making therapeutic decisions for any of these pathological conditions.

Posterior Circulation Mechanical Thrombectomy through Primitive Trigeminal Artery: A Case Report

“…PTA generally occurs on one side and is a relatively rare angiographic variation, which usually originates from the cavernous and petrosal segments of the ICA and terminates in the basilar artery [ 3 , 5 ]. There is currently no unified classification for the PTA; however, the Saltzman classification is commonly used clinically [ 1 ]. Type I is characterized by bilateral supply to the superior cerebellar and posterior cerebral arteries by PTA, with poor development of the proximal basilar artery and bilateral posterior communicating arteries.…”

“…However, in some cases, these vessels persist into adulthood; one is the primitive trigeminal artery (PTA). The prevalence of PTA is approximately 0.1–0.6% [ 1 ]. Generally, PTA is asymptomatic; however, it has been associated with various vascular disorders, including aneurysms, arteriovenous malformations, moyamoya disease, and large vessel occlusion [ 2 ].…”

Persistent Trigeminal Artery Review: Classic and Variant Pattern - Embriology, Anatomic and Radiological Characteristics

“…Vascular disorders frequently accompany observing these arteries, particularly aneurysms. [9,10] Either a malfunction in the inhibition processes can be attributed to the persistence of embryonal vessels or a malfunction in the induction of the vascular changes that typically occur later. The following arteries are considered to be persistent vestigial arteries:…”

Successful endovascular thrombectomy using solitaire FR stent with intermediate catheter assisting technique for acute persistent primitive trigeminal artery and basilar artery occlusion: A case report and literature review

“…[ 3 ] Traditional endovascular thrombectomy (EVT) may be less than ideal, especially when dealing with the complex anatomy of the PPTA. [ 15 , 22 ] This accentuates the pressing need for innovative and advanced therapeutic methods tailored to such intricate cases.…”

“…[3] Traditional endovascular thrombectomy (EVT) may be less than ideal, especially when dealing with the complex anatomy of the PPTA. [15,22] is accentuates the pressing need for innovative and advanced therapeutic methods tailored to such intricate cases. e Solitaire FR (RECO SR)/Stent with Intermediate Catheter Assisting (SWIM) technique has emerged as a promising solution for these challenges.…”