Zhang Kun, Li Chao, Hou Kun, Yu Jinlu
Department of Cerebrovascular Disease, Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, China.
Department of Neurology, First Hospital of Jilin University, Changchun, China.
Front Neurol. 2021 Oct 26;12:761006. doi: 10.3389/fneur.2021.761006. eCollection 2021.
The cervical anterior spinal artery (ASA) is a very important artery arising from the intracranial vertebral artery (VA). It can play different roles in endovascular treatment (EVT) of spinal vascular diseases. The current understanding of these roles is incomplete; therefore, we performed this review. We found that cervical ASA can be involved in many spinal vascular diseases, such as arteriovenous fistula (AVF), arteriovenous malformation (AVM), and aneurysm, and can serve as a collateral channel in proximal VA occlusion. In AVF and AVM, when the cervical ASA is involved, it often plays the role of an accomplice or victim because it acts as the feeder or as a bystander that does not provide blood flow to the AVF and AVM. In cervical ASA aneurysm, the ASA is a victim. During EVT of VA aneurysms or stenoses, the cervical ASA ostia can be covered or occluded, resulting in ASA ischemia. In this situation, the ASA is a victim. In VA occlusion or the subclavian steal phenomenon, the cervical ASA can serve as a collateral channel to provide blood flow to the posterior circulation. In this case, the ASA plays the role of a friend. According to the role of the cervical ASA in spinal vascular diseases, EVT should be determined "case by case." Most importantly, when EVT is performed to treat these diseases, the cervical ASA axis must be preserved. Therefore, understanding the role of the cervical ASA in spinal vascular diseases is crucial.
颈段脊髓前动脉（ASA）是一条起源于颅内椎动脉（VA）的非常重要的动脉。它在脊髓血管疾病的血管内治疗（EVT）中可发挥不同作用。目前对这些作用的认识并不完整；因此，我们进行了本综述。我们发现颈段ASA可累及多种脊髓血管疾病，如动静脉瘘（AVF）、动静脉畸形（AVM）和动脉瘤，并且在近端VA闭塞时可作为侧支通道。在AVF和AVM中，当颈段ASA受累时，它常扮演共犯或受害者的角色，因为它充当供血动脉或作为不向AVF和AVM供血的旁观者。在颈段ASA动脉瘤中，ASA是受害者。在VA动脉瘤或狭窄的EVT过程中，颈段ASA开口可能被覆盖或闭塞，导致ASA缺血。在这种情况下，ASA是受害者。在VA闭塞或锁骨下动脉盗血现象中，颈段ASA可作为侧支通道为后循环提供血流。在这种情况下，ASA扮演朋友的角色。根据颈段ASA在脊髓血管疾病中的作用，EVT应“逐例”确定。最重要的是，在进行EVT治疗这些疾病时，必须保留颈段ASA轴。因此，了解颈段ASA在脊髓血管疾病中的作用至关重要。
