Prevalence and Clinical Implications of the Primitive Trigeminal Artery and its Variants: A Meta-Analysis

Brzegowy, Karolina; Pękala, Przemysław A.; Zarzecki, Michał; Pękala, Jakub R.; Roy, Joyeeta; Aziz, Hasina M.; Tubbs, R. Shane; Walocha, Jerzy; Tomaszewski, Krzysztof A.; Mikoś, Marcin

doi:10.1016/j.wneu.2019.09.042

Cited by 17 publications

(13 citation statements)

References 47 publications

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“…The most common offending vessels are the SCA, AICA and vertebrobasilar trunk 133 , 134 . Very rarely, TN could result from the PICA associated with the PTA as mentioned before 31 . Several cases demonstrated that the artery that originated from the PTA and terminated as the sole PICA caused TN 134 , 135 .…”

Section: Neurovascular Compression Syndromementioning

confidence: 97%

“…PICAs origins from other arteries such as internal carotid artery, primitive hypoglossal artery, primitive trigeminal artery and posterior meningeal artery have also been reported 27 - 30 . Rarely, the variation of primitive trigeminal artery (PTA), which is the most common persistent carotid-basilar anastomose, could originate from internal carotid and continue as PICA 31 . The anatomic variants of PICA are shown in Figure 2 A-F.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Importance of the Posterior Inferior Cerebellar Artery: A Review of the Literature

Miao¹,

Zhang²,

Wang³

et al. 2020

Int. J. Med. Sci.

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The posterior inferior cerebellar artery (PICA), with its unique anatomical complexity, is of great clinical importance and involved in many diseases including aneurysm, ischemic stroke, neurovascular compression syndrome (NVCS), arteriovenous malformation (AVM), and brain tumor. However, a comprehensive systematic review of the importance of the PICA is currently lacking. In this study, we perform a literature review of PICA by searching all the associated papers in the PUBMED database hoping to provide a better understanding of the artery. The PICA has tortuous and variable course and territory, divided into 5 segments. Various aneurysms involving PICA were not uncommon, of which the treatment is challenging. The PICA infarct typically manifests lateral medullary syndrome (LMS) and is more likely to cause mass effects. The PICA frequently compresses the medulla and the cranial nerves resulting in various neurovascular compression syndromes (NVCS). Arteriovenous malformation (AVM) fed by PICA are associated with aneurysm and dissection which have high risk of rupture and worse outcome. PICA injured by head trauma can cause fatal SAH. VA terminating in PICA probably cause Bow hunter's syndrome (BHS). The PICA supplies many brain tumors and can be used in intracerebellar chemotherapy. The PICA can be exposed and injured during surgeries especially in telovelar approach, and it also plays an important role in bypass surgeries, hinting the surgical importance of PICA. In conclusion, PICA is very important in clinical practice.

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Section: Neurovascular Compression Syndromementioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Clinical Importance of the Posterior Inferior Cerebellar Artery: A Review of the Literature

Miao¹,

Zhang²,

Wang³

et al. 2020

Int. J. Med. Sci.

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show abstract

“…In some cases pontine perforating branches of PTA are observed [3,23,33]. The incidence of PTA varies from 0.1-0.6% [11] and according to some studies is higher in women [5,22]. In most cases the right or none-sided predominance of the PTA is detected.…”

Section: Discussionmentioning

confidence: 97%

Persistent trigeminal artery as a rare cause of vertebrobasilar insufficiency

et al. 2022

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The persistent trigeminal artery (PTA) is the most common fetal carotid-basilar anastomosis which may persist into adult life. In the literature there are numerous papers referring to the anatomical characteristics of this anomalous vessel. In the majority of cases PTA is an incidental finding and its clinical significance has been debated. Some authors describe the coincidence of PTA with various clinical syndromes. However, there are few reports linking PTA with the symptoms of vertebrobasilar insufficiency. We present a patient with a 3-year history of recurrent dizziness and impaired vision, precipitated by physical activity, in whom neuroimaging techniques revealed a persistent left trigeminal artery (PTA). In our case the occurrence of PTA might have been related to the clinical manifestation and the potential mechanism will be discussed.

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“…In MT for cases with PPTA, the posterior circulation approach is often difficult because 42.5% of PPTAs often have a hypoplastic BA, and MT must be performed via the PPTA ( 17 , 65 ). In a report by Imahori et al ( 62 ), a patient suffered acute occlusions of the middle cerebral artery (MCA) and BA; MCA occlusion was given conversative treatment, BA occlusion was successfully treated by MT via the PPTA, and the patient survived after MT.…”

Section: Role In Acute Large Vessel Occlusionmentioning

confidence: 99%

“…Except for the Salas classification of the PPTA, the most common is the modified Saltzman classification (types I, II, and III) (10,(14)(15)(16)(17). Saltzman type I PPTA enters the BA between the SCA and AICA; the PPTA supplies the BA, SCAs, and posterior cerebral arteries (PCAs); the posterior communicating arteries (PcomAs), vertebral artery (VA) and proximal BA may be absent or hypoplastic, and this hypoplasia should not be confused with stenosis (Figure 2C).…”

Section: Angiographic Characteristicsmentioning

confidence: 99%

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

Wang

2022

Front. Neurol.

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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.

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Prevalence and Clinical Implications of the Primitive Trigeminal Artery and its Variants: A Meta-Analysis

Cited by 17 publications

References 47 publications

Clinical Importance of the Posterior Inferior Cerebellar Artery: A Review of the Literature

Clinical Importance of the Posterior Inferior Cerebellar Artery: A Review of the Literature

Persistent trigeminal artery as a rare cause of vertebrobasilar insufficiency

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

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