Khatri Rakesh, Qureshi Mohtashim Arbaab, Chaudhry Mohammad Rauf A, Maud Alberto, Vellipuram Anantha Ramana, Cruz-Flores Salvador, Rodriguez Gustavo Jose
Department of Neurology, Texas Tech University of Health Sciences Center, El Paso, Texas, USA.
Interv Neurol. 2020 Jan;8(2-6):231-241. doi: 10.1159/000502545. Epub 2019 Sep 25.
The middle cerebral artery (MCA) is the most commonly treated artery in mechanical thrombectomy stroke trials; however, there is no pragmatic agreement about the segmental anatomy and nomenclature utilized. It results in significant clinical-radiological dissociation and introduces bias in research trials. The purpose of the study is to review and compare angiographic anatomy with microsurgical anatomy literature of the MCA with emphasis on the discrepancy.
Consecutive cerebral angiograms between January 2011 and March 2014 were retrospectively reviewed by endovascular surgical neuroradiologists. Information about the anatomy of the sphenoidal segment of the MCA classified as classic and non-classic pattern, the lenticulostriate artery takeoff pattern, and the course angulation of the sphenoidal segment were studied.
A total of 500 patients, 886 cerebral angiograms, were reviewed. We found the classic pattern of the main trunk MCA bifurcation and a straight angulation course in less than half of the cases. The lenticulostriate arteries arose not only from the main trunk but also from its divisions in more than half of the cases.
It is important to corroborate our findings and to develop a pragmatic classification to accurately assess MCA occlusions from the radiological and clinical perspective.
大脑中动脉（MCA）是机械取栓治疗卒中试验中最常治疗的动脉；然而，对于所采用的节段性解剖结构和命名尚无实用的共识。这导致了显著的临床与影像学分离，并在研究试验中引入了偏差。本研究的目的是回顾并比较MCA的血管造影解剖与显微外科解剖文献，重点关注差异之处。
血管内手术神经放射科医生对2011年1月至2014年3月期间的连续脑血管造影进行了回顾性研究。研究了MCA蝶骨段解剖结构的相关信息，包括经典型和非经典型模式、豆纹动脉的起始模式以及蝶骨段的走行角度。
共回顾了500例患者的886次脑血管造影。我们发现，不到一半的病例中出现主干MCA分叉的经典模式和直线走行角度。超过一半的病例中，豆纹动脉不仅起源于主干，还起源于其分支。
证实我们的发现并制定实用的分类方法，以便从放射学和临床角度准确评估MCA闭塞情况非常重要。
