Mulder Mjhl, Lycklama À Nijeholt G J, Dinkelaar W, de Rooij Tpw, van Es Acgm, van der Kallen B F, Emmer B J
Department of Neurology, Erasmus MC University Medical Center Rotterdam, the Netherlands
Department of Radiology, Medisch Centrum Haaglanden, The Hague, the Netherlands.
Interv Neuroradiol. 2015 Dec;21(6):715-8. doi: 10.1177/1591019915609122. Epub 2015 Oct 13.
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.
我们描述了一例患有持续性原始三叉动脉（PPTA）的患者急性后循环闭塞的动脉内治疗（IAT）情况。该患者表现为急性左侧偏瘫和意识丧失（格拉斯哥昏迷评分为5分）。计算机断层血管造影显示右侧颈内动脉（ICA）、PPTA、基底动脉远端（BA）、右侧大脑后动脉（PCA）和右侧小脑上动脉（SCA）急性闭塞。由于近端BA发育不全，无法通过其进行支架取栓术。在通过近端ICA闭塞部位后，通过PPTA对右侧PCA和SCA进行了再通，仅进行了一次取栓手术。干预后10天，患者出院，改良Rankin量表（mRS）评分为0分，仅遗留轻度面部和左手轻瘫。PPTA是一种持续存在的胚胎期颈-基底连接。在规划和实施急性神经介入手术时，了解神经血管解剖结构中现有的（胚胎期）变异至关重要。
