A Type 1 Persistent Proatlantal Artery Originating from the External Carotid Artery Detected by Computed Tomographic Angiography

Vertebral artery (VA)-posterior inferior cerebellar artery (PICA) aneurysms are rare lesions that are difficult to treat with both endovascular and surgical techniques. Tight angulation of the PICA from VA may make access to the PICA difficult from ipsilateral VA if adjunctive techniques are needed. Recently, the safety and efficacy of retrograde access have been reported. We report a case of endovascular treatment for a VA-PICA aneurysm with a stent-assisted technique using retrograde access via contralateral persistent primitive proatlantal artery (PPA). The patient was a 76-year-old woman with an unruptured VA-PICA aneurysm on the dominant VA side. Coil embolization with a stent-assisted technique using retrograde access seemed appropriate. However, the origin of the left VA was not confirmed. Left common carotid artery angiography demonstrated that the PPA (type 1) branching from external carotid artery joined the VA V4 segment. Retrograde access via the PPA for stenting was performed. A microcatheter for stenting was retrogradely advanced to the right PICA at ease. After deploying the stent, coil insertion was completed from the right VA, and the final angiogram showed adequate occlusion of the aneurysm with preservation of the PICA. Thus, PPA may be an approach route in the treatment of VA-PICA aneurysms with unconfirmed contralateral VA orifice and apparent PPA on angiography, when retrograde access is needed.

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Detection of common carotid artery stenosis using duplex ultrasonography: A validation study with computed tomographic angiography

Journal of Vascular Surgery ◽

10.1016/j.jvs.2009.08.002 ◽

2010 ◽

Vol 51 (1) ◽

pp. 65-70 ◽

Cited By ~ 18

Author(s):

David P. Slovut ◽

Javier M. Romero ◽

Kathleen M. Hannon ◽

James Dick ◽

Michael R. Jaff

Keyword(s):

Carotid Artery ◽

Validation Study ◽

Common Carotid Artery ◽

Carotid Artery Stenosis ◽

Computed Tomographic Angiography ◽

Artery Stenosis ◽

Duplex Ultrasonography ◽

Computed Tomographic ◽

Tomographic Angiography

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Assessment of Anatomical Risk Factors for Carotid Artery Stenting: Comparison of Spiral Computed Tomographic Angiography with Digital Subtraction Angiography

Heart Lung and Circulation ◽

10.1016/j.hlc.2007.06.352 ◽

2007 ◽

Vol 16 ◽

pp. S140

Author(s):

T. Gattorna ◽

C. Chawantanpipat ◽

M. Stephen ◽

C. Anderson ◽

S. McCormack ◽

...

Keyword(s):

Risk Factors ◽

Carotid Artery ◽

Digital Subtraction Angiography ◽

Carotid Artery Stenting ◽

Computed Tomographic Angiography ◽

Digital Subtraction ◽

Spiral Computed ◽

Computed Tomographic ◽

Tomographic Angiography

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Improved Imaging of Carotid Artery Bifurcation Using Helical Computed Tomographic Angiography

Annals of Vascular Surgery ◽

10.1007/s100169900238 ◽

1999 ◽

Vol 13 (2) ◽

pp. 178-183 ◽

Cited By ~ 14

Author(s):

Marianne E. Cinat ◽

Hanh Pham ◽

David Vo ◽

Ian Gordon ◽

Samuel E. Wilson

Keyword(s):

Carotid Artery ◽

Computed Tomographic Angiography ◽

Computed Tomographic ◽

Carotid Artery Bifurcation ◽

Tomographic Angiography

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Preoperative Embolization of Intracranial Meningiomas

Neurosurgery ◽

10.1227/00006123-198309000-00008 ◽

1983 ◽

Vol 13 (3) ◽

pp. 261-268 ◽

Cited By ~ 66

Author(s):

Hans-Peter Richter ◽

Walter Schachenmayr

Keyword(s):

Carotid Artery ◽

Histopathological Examination ◽

External Carotid Artery ◽

External Carotid ◽

Intracranial Meningioma ◽

Preoperative Embolization ◽

Computed Tomographic ◽

Intracranial Meningiomas ◽

Feeding Vessels ◽

Lyophilized Dura Mater

Abstract The operative and histopathological findings in 31 cases of intracranial meningioma after preoperative embolization with Gelfoam and/or lyophilized dura mater are reported. Removal of the tumor after embolization was facilitated in those meningiomas fed exclusively or mainly by branches of the external carotid artery (29 of 31). Large areas of tumor necrosis were never seen on histopathological examination, even when suggested by large regions of decreased density on the postembolization computed tomographic scan. Preoperative embolization of the feeding vessels arising from the external carotid artery system has proven to be a useful adjunct before the resection of intracranial meningiomas.

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Facial Arterial Variations in Asians: A Study on Computed Tomographic Angiography

Aesthetic Surgery Journal ◽

10.1093/asj/sjab380 ◽

2021 ◽

Author(s):

Dawei Wang ◽

Shixuan Xiong ◽

Ning Zeng ◽

Yiping Wu

Keyword(s):

Computed Tomographic Angiography ◽

Facial Artery ◽

Nasolabial Fold ◽

Anatomical Landmarks ◽

Filler Injection ◽

Computed Tomographic ◽

Arterial Variations ◽

Significant Difference ◽

Tomographic Angiography

Abstract Background A consensus on facial artery (FA) anatomy has not been established due to the discrepancies in previous studies. Objectives The purpose of this study was to assess the branches, course, and location of the FA in Asians utilizing computed tomographic angiography (CTA). Methods The CTA images of 300 FAs from 150 Asian patients were evaluated. According to the termination branch, the FA was classified as follows: type 1, FA terminates superior labial or inferior labial artery; type 2: FA terminates lateral nasal or inferior alar artery; type 3: FA terminates medial canthal artery; type 4: FA is divided into duplex branches with dominant medial canthal artery laterally. The relationship between nasolabial fold and FA was evaluated, and the distances from anatomical landmarks to FA were measured to position the course. Results 70 arteries (23.3%), 163 arteries (54.3%), 49 arteries (16.3%), and the other 18 arteries (6.0%) were classified as type 1, 2, 3 and 4, respectively. 72.3% of FAs were located medially to the nasolabial fold, and only 14.7% of arteries were lateral to the nasolabial fold. The vertical distance between FA and the inner canthus or the midpoint of inferior orbital rim decreased from type 1 to type 4 FA (P < 0.0001). No significant difference was found among the four types of FA in the distances between the mandibular angle (P = 0.1226) or oral commissure (P = 0.1030) and the FA at inferior of mandible. Conclusions The detailed findings of facial artery will provide a valuable reference for filler injection in cosmetic procedures and flap design in reconstructive surgery.

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Giant scalp arteriovenous malformation

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.62.09.828 ◽

2016 ◽

Vol 62 (9) ◽

pp. 828-830 ◽

Cited By ~ 3

Author(s):

PAULO VALDECI WORM ◽

LEONARDO GILMONE RUSCHEL ◽

MARCELO ROSA ROXO ◽

RAFAEL CAMELO

Keyword(s):

Literature Review ◽

Physical Examination ◽

Arteriovenous Malformations ◽

Surgical Excision ◽

Computed Tomographic Angiography ◽

External Carotid ◽

Carotid Angiography ◽

Computed Tomographic ◽

The Subject ◽

Tomographic Angiography

SUMMARY Arteriovenous malformations (AVMs) of the scalp are rare lesions. The clinical picture presents with complaints of increased scalp, scalp disfigurement, pain and neurological symptoms. Its origin can be congenital or traumatic. We present a case of giant scalp AVMs and its management, followed by a brief literature review on the subject. The diagnosis of scalp AVMs is based on physical examination and confirmed by internal and external carotid angiography or computed tomographic angiography (CTA). Surgical excision is especially effective in scalp AVMs, and is the most frequently used treatment modality.

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