The branching pattern of the middle cerebral artery: is the intermediate trunk real or not? An anatomical study correlating with simple angiography

Kahiloğulları, Gökmen; Ugur, Hasan Çağlar; Cömert, Ayhan; Tekdemi̇r, İbrahi̇m; Kanpolat, Yücel

doi:10.3171/2012.1.jns111013

Cited by 28 publications

(32 citation statements)

References 30 publications

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“…This observation is underlined by previous microsurgical studies which demonstrated a higher frequency of dominant inferior trunks compared with superior trunks 15 16. However, our rate is higher than the aforementioned studies, which found inferior trunks to be dominant in up to 54% 15. This can be explained by the fact that our study design only allowed the classification of trunks as dominant and non-dominant, even in cases where differentiation of vessel caliber was difficult.…”

Section: Discussioncontrasting

confidence: 70%

Stent retriever placement in embolectomy: the choice of the post-bifurcational trunk influences the first-pass reperfusion result in M1 occlusions

Maus

Tsogkas

Henkel

et al. 2018

J NeuroIntervent Surg

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Section: Discussioncontrasting

confidence: 70%

Stent retriever placement in embolectomy: the choice of the post-bifurcational trunk influences the first-pass reperfusion result in M1 occlusions

Maus

Tsogkas

Henkel

et al. 2018

J NeuroIntervent Surg

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“…After this date, some important progress was achieved in parallel with hardware and software advancement in computer technology as well as image processing technology in neurological radiology. according to literature records, it may be concluded that cadaveric and CT angiographic measurements are similar and overlap with each other (3,6). This may provide considerable intraoperative safety in surgical approaches related to anatomical structures such as OphA.…”

Section: █ Discussionmentioning

confidence: 88%

Three dimensional microanatomy of the ophtalmic artery: spontaneous intracranial-extracranial anastomosing site within the orbital cavity

Kuruoğlu¹,

Çokluk²,

Marangoz³

et al. 2014

Turkish Neurosurgery

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The volume rendering technique may be used in the threedimensional evaluation of some anatomical structures such as Opha. The volume rendering technique is a group of modalities in the conversion of two-dimensional images to threedimensional images (2, 5, 12). The two-dimensional images acquired by computerized tomography (CT) and magnetic resonance imaging is used to create the volume rendered images (2, 4, 5). Three-dimensional (3D) reconstructed images accurately reflect the real measurement in patients who have undergone multislice helical CT examination (15). In this study, we used the OsiriX software program for volume rendering technique to create three-dimensional ophthalmic artery images. The results of this study and the feasibility of this technique are discussed under the light of published medical literature. █ InTRODuCTIOnThe ophthalmic artery (OphA) is the first branch of the internal carotid artery distal to the cavernous sinus. The OphA supplies the structures within the orbit as well as some structures in the nose, face and meninges. The Opha arises from the internal carotid along the medial side of the anterior clinoid process and runs anteriorly passing through the optic canal inferolaterally to the optic nerve. The central retinal artery (CRA) is the first, and one of the smaller branches of the OphA. The next branch of the OphA is the lacrimal artery. It is one of the largest branches within the orbital cavity.The supraorbital artery is the second major branch of the OphA. Around the supraorbital notch, the OphA has some critical spontaneous intracranial-extracranial anastomoses with the terminal branches of the facial artery. AIM:The aim was to evaluate three-dimensional structure of the ophthalmic artery (Opha). MATERIAl and METhODS:The raw data of the Three-dimensional Computerized Tomography Angiography (3D-CTA) were transferred to computer and recorded in a software program. RESulTS:The study group consisted of 45 (24 female and 21 male) patients. The mean age of the patients was 56±9.5 years. It was found that the entry point of the OphA to the orbital cavity was inferior to the optic foramen in 29 (64.44%) of the cases. The length of the postcanalicular-prelacrimal was 0.54±0.13 centimeters at the right side and 0.51±0.13 centimeters at the left side. The distance of the postlacrimal-presupraorbital segment was 0.43±0.11 centimeters at the right and left sides. The location of the anastomosing site was 0.97± 0.42 centimeters from the supraorbital notch. COnCluSIOn:The results of this study showed us that this technique could be used in the evaluation of the three-dimensional microsurgical anatomy of the OphA and its critical extracranial-intracranial anastomosing site.

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“…If the intermediate trunk cannot be selected, the operator should aim for the selection of a branch of the inferior division. It has been reported that the inferior division is most commonly the dominant division counting with the largest diameter [8]. …”

Section: Discussionmentioning

confidence: 99%

“…The precentral, central and postcentral (also known as the anterior parietal) arteries usually arise from the intermediate trunk. These branches give the blood supply to the primary somatosensory cortex [8]. …”

Section: Methodsmentioning

confidence: 99%

Main Trunk and Division Middle Cerebral Artery Occlusions: Differences in Recanalization Times, Number of Stent Retriever Passes and Clinical Outcomes: A Single-Center Experience

Qureshi¹,

Maud²,

Cruz‐Flores³

et al. 2015

Intervent Neurol

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Background and Purpose: In this article, we present our experience with the recanalization of the middle cerebral artery (MCA), we hypothesize that there are higher rates of recanalization with fewer stent retriever passes and better clinical outcomes in patients with division MCA occlusions. A more complex anatomy at the bifurcation may prevent a faster recanalization in main trunk MCA occlusions. Methods: We retrospectively identified consecutive patients admitted with MCA occlusions who underwent mechanical thrombectomy using stent retrievers. We categorized patients into division MCA and main trunk MCA occlusions based on angiography. Variables were compared between the groups. We further analyzed patients with trunk MCA occlusions to identify reasons for delays in recanalization. Results: There were 32 MCA occlusions that underwent mechanical thrombectomy and eligible for the analysis during the study period. Of those, 11 were main trunk MCA occlusions. Univariate analysis disclosed a trend toward a lower GP-to-recanalization time (p = 0.05) and a lower number of passes required for recanalization in division MCA occlusions. However, there was a significantly better outcome in patients with division MCA occlusion after multivariate analysis. Analyzing main trunk MCA occlusion data, we found that the need for more than one pass to achieve recanalization led to a trend toward a longer GP-to-recanalization time and a worse outcome. When the stent was placed in the dominant division, the chances of recanalization were significantly higher. Conclusions: Division MCA occlusions have higher recanalization rates with fewer stent retriever passes and better clinical outcomes than main trunk MCA occlusions, likely due to a more favorable anatomy. Measures like placing the stent retriever in the dominant division may decrease recanalization times and improve clinical outcomes in main trunk MCA occlusions.

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The branching pattern of the middle cerebral artery: is the intermediate trunk real or not? An anatomical study correlating with simple angiography

Cited by 28 publications

References 30 publications

Stent retriever placement in embolectomy: the choice of the post-bifurcational trunk influences the first-pass reperfusion result in M1 occlusions

Stent retriever placement in embolectomy: the choice of the post-bifurcational trunk influences the first-pass reperfusion result in M1 occlusions

Three dimensional microanatomy of the ophtalmic artery: spontaneous intracranial-extracranial anastomosing site within the orbital cavity

Main Trunk and Division Middle Cerebral Artery Occlusions: Differences in Recanalization Times, Number of Stent Retriever Passes and Clinical Outcomes: A Single-Center Experience

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