scholarly journals Thrombectomy in posterior circulation stroke through persistent primitive trigeminal artery: A case report

2015 ◽  
Vol 21 (6) ◽  
pp. 715-718 ◽  
Author(s):  
MJHL Mulder ◽  
GJ Lycklama à Nijeholt ◽  
W Dinkelaar ◽  
TPW de Rooij ◽  
ACGM van Es ◽  
...  
Keyword(s):  
Posterior Circulation ◽  
Superior Cerebellar Artery ◽  
Trigeminal Artery ◽  
Left Hand ◽  
Persistent Primitive Trigeminal Artery ◽  
Cerebellar Artery ◽  
Intervention Patient ◽  
Primitive Trigeminal Artery ◽  
The Right ◽  
Neurovascular Anatomy

We describe a case of intra-arterial treatment (IAT) of acute posterior circulation occlusion in a patient with a persistent primitive trigeminal artery (PPTA). The patient presented with an acute left sided hemiparesis and loss of consciousness (Glasgow coma score of 5). Computed tomography angiography showed an acute occlusion of the right internal carotid artery (ICA), the PPTA, distal basilar artery (BA), right posterior cerebral artery (PCA), and right superior cerebellar artery (SCA). Stent-retriever assisted thrombectomy was not considered possible through the hypoplastic proximal BA. After passage of the proximal ICA occlusion, the right PCA and SCA were recanalized through the PPTA, with a single thrombectomy procedure. Ten days after intervention patient was discharged scoring optimal EMV with only a mild facial and left hand paresis remaining. PPTA is a persistent embryological carotid–basilar connection. Knowledge of existing (embryonic) variants in neurovascular anatomy is essential when planning and performing acute neurointerventional procedures.

scholarly journals Double-Balloon Remodeling for Coil Embolization of a Primitive Trigeminal Artery Variant Aneurysm

2014 ◽  
Vol 20 (3) ◽  
pp. 295-300 ◽  
Author(s):  
Tomoji Takigawa ◽  
Kensuke Suzuki ◽  
Yoshiki Sugiura ◽  
Ryotaro Suzuki ◽  
Issei Takano ◽  
...  
Keyword(s):  
Coil Embolization ◽  
Superior Cerebellar Artery ◽  
Anterior Inferior Cerebellar Artery ◽  
Trigeminal Artery ◽  
Occlusion Balloon ◽  
Double Balloon ◽  
Persistent Primitive Trigeminal Artery ◽  
Cerebellar Artery ◽  
Primitive Trigeminal Artery ◽  
The Right

Here we describe the case of a patient with a wide-necked unruptured aneurysm arising at origin of a persistent primitive trigeminal artery (PTA) variant from the right internal carotid artery (ICA), supplying the territory of the right superior cerebellar artery and the anterior inferior cerebellar artery. To preserve the ICA and the PTA variant, coil embolization of the aneurysm was performed using a double-balloon remodeling technique (HyperForm™ and Hyper-Glide™ Occlusion Balloon Systems; ev3 Endovascular Inc., Irvine, CA, USA). The association of a PTA variant with an aneurysm is very rare. To our knowledge, this is the first description of the use of coil embolization using double-balloon remodeling to treat a PTA variant aneurysm. This technique permits complete embolization and reduces the risk of cerebral and cerebellar ischemia.

Classification of persistent primitive trigeminal artery (PPTA): a reconsideration based on MRA

2011 ◽  
Vol 52 (9) ◽  
pp. 1043-1051 ◽  
Author(s):  
Young Cheol Weon ◽  
Seong Hoon Choi ◽  
Jae Cheol Hwang ◽  
Shang Hun Shin ◽  
Woon-Jung Kwon ◽  
...  
Keyword(s):  
Basilar Artery ◽  
Vascular Anatomy ◽  
Trigeminal Artery ◽  
Non Invasive ◽  
Persistent Primitive Trigeminal Artery ◽  
Primitive Trigeminal Artery ◽  
The Right ◽  
Type 3 ◽  
Relationship Of

Background Persistent primitive trigeminal artery (PPTA) is the most common permanent carotid-basilar anastomosis. Magnetic resonance angiography (MRA) has become the primary non-invasive imaging technique for evaluation of cerebral vascular anatomy and can provide detailed 3D imaging of intracranial vessels. Purpose To evaluate the usefulness of MRA for the detection of PPTA and to re-classify its variations based on the embryologic types of PcomA and its relationship with the basilar artery and its branches. Material and Methods Of the total 7329 patients who underwent MRA at our institution from March 2008 through November 2010, we retrospectively analyzed the MRAs of 24 patients with a PPTA. Special attention was given to defining the relationship of the PPTA and the basilar artery with PcomA and to determine the site of origin, size, and course of the PPTA. The PPTA classification included five types based on their anatomic relationship to the neighboring arteries. Clinical features and associated vascular anomalies are also described. Results Twenty-four (17 women and seven men, 34 ∼ 81 years of age, mean age 59.67 years) of the 7329 patients had a PPTA (0.33 %). Eleven cases (45.8%) were classified as type 1, three (12.5%) as type 2, five (20.8%) as type 3, one (4.2%) as type 4, and four (16.7%) as type 5b. Fifteen PPTAs (62.5%) were located on the left side and nine were located (37.5%) on the right side. The basilar artery proximal to the insertion of the PPTA showed severe to moderate hypoplasia in 13 cases (54%). Nine intracranial artery aneurysms were detected in seven (29%) of the 24 study patients. Conclusion This study revealed five types of PPTA and necessitates an adjustment of the previous classification of PPTA on the basis of our MRA examinations. A PPTA should be considered by both the clinician and the radiologist who interpret MR angiography.

scholarly journals Post-Traumatic Cavernous Fistula Fed by Persistent Trigeminal Artery: Treatment by GDC Embolisation

2001 ◽  
Vol 7 (1) ◽  
pp. 47-50 ◽  
Author(s):  
P.S. Deol ◽  
N.K. Mishra ◽  
V. Gupta ◽  
S.B. Gaikwad ◽  
A. Garg ◽  
...  
Keyword(s):  
Cavernous Sinus ◽  
Posterior Circulation ◽  
Persistent Trigeminal Artery ◽  
Trigeminal Artery ◽  
Cavernous Fistula ◽  
Persistent Primitive Trigeminal Artery ◽  
Balloon Embolisation ◽  
Post Traumatic ◽  
Primitive Trigeminal Artery

A case of traumatic persistent primitive trigeminal artery (PPTA) cavernous sinus fistula treated with GDC embolisation is reported. Because of the small lumen of PPTA, posteriorly directed course and flow contribution from the posterior circulation, balloon embolisation via the carotid system was not considered appropriate. The fistula was successfully closed by GDC embolisation.

scholarly journals Combined Neuroform Intracranial Stent and Bioactive Matrix Detachable Coil for Embolization of a Broad-Necked Persistent Primitive Trigeminal Artery Aneurysm

2005 ◽  
Vol 11 (1) ◽  
pp. 63-68 ◽  
Author(s):  
Q.P. Zhao ◽  
T.L. Li ◽  
C.Z. Duan ◽  
G.Z. Chen
Keyword(s):  
Artery Aneurysm ◽  
Parent Artery ◽  
Trigeminal Artery ◽  
Detachable Coil ◽  
Intracranial Stent ◽  
Persistent Primitive Trigeminal Artery ◽  
Detachable Coils ◽  
Primitive Trigeminal Artery ◽  
The Right ◽  
Neuroform Stent

We report a patient with a wide-necked aneurysm arising at the bifurcation of the right internal carotid artery and the persistent primitive trigeminal artery (PPTA) treated successfully by Matrix detachable coil occlusion and assisted by a Neuroform intracranial stent. First, a Neuroform self-expanding intracranial stent was delivered via a 5-F Guider Softtip XP and placed as desired, then the aneurysm dome was embolized with two Matrix detachable coils through the interstices of the stent. The aneurysm was 80% occluded angiographically and the parent artery was patent. DSA imaging six months after the procedure showed the aneurysm to be obliterated at angiography and the neck tissue thickness of the aneurysm to be increased, but the parent artery diameter was not impacted. We describe the case in detail and discuss our preliminary experience of using the Neuroform stent and Matrix detachable coils for the treatment of a PPTA wide-necked aneurysm.

Cavernous sinus fistula caused by intracavernous rupture of a persistent primitive trigeminal artery

1984 ◽  
Vol 61 (2) ◽  
pp. 391-395 ◽  
Author(s):  
Mitchel S. Berger ◽  
Yoshio Hosobuchi
Keyword(s):  
Cavernous Sinus ◽  
Surgical Approach ◽  
Posterior Circulation ◽  
Trigeminal Artery ◽  
Vertebral Angiography ◽  
Content Type ◽  
Persistent Primitive Trigeminal Artery ◽  
Primitive Trigeminal Artery ◽  
Balloon Embolization ◽  
Fine Print

✓ A persistent carotid-basilar anastomosis (primitive trigeminal artery), identified by four-vessel vertebral angiography, was shown to be the cause of a cavernous sinus fistula in a 51-year-old woman. The fistula, but not the primitive artery, was identified on a carotid arteriogram. Because of the flow contribution from the posterior circulation, balloon embolization via the carotid system failed, and the fistula was repaired through a direct surgical approach. The operative technique is described and the hemodynamic aspects of a cavernous sinus fistula that is related to this primitive anastomosis are reviewed.

Moyamoya disease associated with persistent primitive trigeminal artery

1983 ◽  
Vol 59 (1) ◽  
pp. 166-171 ◽  
Author(s):  
Ryungchan Kwak ◽  
Satoru Kadoya
Keyword(s):  
Moyamoya Disease ◽  
Vascular Anomaly ◽  
Intracerebral Hematoma ◽  
Trigeminal Artery ◽  
Vascular Abnormality ◽  
Content Type ◽  
Persistent Primitive Trigeminal Artery ◽  
Developmental Relationship ◽  
Primitive Trigeminal Artery ◽  
The Right

✓ Two cases of moyamoya disease associated with persistent primitive trigeminal artery (PTA) are reported. The first patient was a 44-year-old man who experienced a sudden severe headache brought about by an intracerebral hematoma in the left temporoparietal lobe. Four-vessel study showed a right-sided PTA and moyamoya disease. The second patient was a 56-year-old woman with similar symptoms and a hematoma in the right temporoparietal lobe. Four-vessel study showed a left-sided PTA and moyamoya disease. Among the 212 PTA cases reported in the literature, none has been associated with moyamoya disease. Moreover, there are no cases of moyamoya disease among the 119 cases of persistent primitive hypoglossal artery (PHA), which is thought to be a vascular anomaly fundamentally similar to PTA. None of the 907 cases of moyamoya disease reported in Japan has been associated with either PTA or PHA. Nonetheless, the embryonic stage when PTA or PHA normally disappears partially overlaps that period when moyamoya-like vascular anomalies have been thought to arise. The possible developmental relationship beween these two varieties of vascular abnormality is discussed.

Carotid-cavernous sinus fistula caused by rupture of a primitive trigeminal artery aneurysm

1977 ◽  
Vol 46 (3) ◽  
pp. 373-376 ◽  
Author(s):  
Takao Enomoto ◽  
Akira Sato ◽  
Yutaka Maki
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Artery Aneurysm ◽  
Trigeminal Artery ◽  
Content Type ◽  
Persistent Primitive Trigeminal Artery ◽  
Carotid Cavernous Sinus Fistula ◽  
Primitive Trigeminal Artery ◽  
The Right

✓ A case is reported in which an aneurysm arising at the junction of the right internal carotid artery and a persistent primitive trigeminal artery ruptured to form a carotid-cavernous fistula. The internal carotid artery was ligated without any signs of brainstem ischemia due to inverted blood flow through the primitive trigeminal artery.

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