Persistent trigeminal artery detected on computed tomography angiography

Abstract

This study aimed to investigate the prevalence of persistent trigeminal arteries (PTAs) using computed tomography (CT) angiography, emphasize its major characteristics, and compare the ndings with those reported in the relevant literature. MethodsPatients who underwent cerebral CT angiography in our radiology clinic for any preliminary diagnosis between December 2013 and December 2020 were included in this retrospective study. The patients were reviewed in terms of their age, sex, and the presence of PTAs. The localization of the PTA, vascular connection, PTA type (according to Saltzman and Salas classi cation), and vascular pathology at the level of anastomoses were examined in the patients with PTAs. ResultsA total of 1150 patients, (632 [55%] males and 518 [45%] females) were included in this study. A total of seven (0.6%) patients had PTAs. PTAs were located on the right and left sides in 3 (43%) and 4 (57%) patients, respectively. A total of 3 (43%), 2 (28%), and 2 (28%) cases were classi ed as types I, II, and III PTA based on the Saltzman classi cation, respectively. Moreover, 4 (57%) and 3 (43%) cases were lateral and medial types based on the Salas classi cation, respectively. ConclusionIn conclusion, understanding the diagnosis and classi cation of PTAs is crucial for the diagnosis of possible vascular pathologies by neuroradiologists and physicians performing neurovascular interventional procedures or operations. If these vascular pathologies remain undetected, they may cause fatal bleeding or embolism during surgeries and endovascular procedures.

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 ].…”

“…A meta-analysis demonstrated that 42.5% of patients with PTA have poor basilar artery development, leading to reduced blood supply in the posterior circulation [ 5 ]. In this scenario, blood flow through the PTA was directed from the ICA toward the basilar artery, making PTA a potential embolic pathway and significantly increasing the risk of posterior circulation embolism and ischemic stroke [ 3 , 4 ]. Therefore, we believe that the basilar artery occlusion in this patient was most likely an acute embolism from the anterior circulation entering the basilar artery through the PTA.…”

“…Generally, PTA is asymptomatic; however, it has been associated with various vascular disorders, including aneurysms, arteriovenous malformations, moyamoya disease, and large vessel occlusion [ 2 ]. Recently, PTA has also been reported to increase the risk of ischemic stroke [ 3 , 4 ]. However, there are limited reports on PTA-related surgical treatments, which may be attributed to the PTA variants, tortuous course, small caliber, frequent association with vertebrobasilar artery dysplasia, and the difficulty and risk of the operation through PTA.…”

Medial-type persistent trigeminal artery and ipsilateral posterior communicating artery supplying bilateral posterior cerebral arteries combined with an aberrant right subclavian artery and bicarotid trunk

“…The lateral type is the usual type, and approximately 90% of PTAs are classi ed as this type [2,5,11]. Medialtype PTAs are rare; however, Deniz et al [1] recently reported that 3 of 7 PTAs were medial-type. The medial type runs in the pituitary fossa; thus, it is also called intrasellar PTA and is dangerous during transsphenoidal pituitary surgery.…”

Persistent Trigeminal Artery - Anatomical Features and Clinical Significance

“…Several fetal anastomoses have been described between the carotid and vertebrobasilar circulations [1][2][3][4][5][6][7][8][9][10][11]. These anastomoses regress while the P1 segments develop, but they can occasionally persist in adult age [1][2][3][4][5][6][7][8][9][10][11].…”