Department of Radiology, Saitama Sekishinkai Hospital, 2-37-20 Irumagawa, Sayama, Saitama, 350-1305, Japan.
Department of Neuroendovascular Therapy, Saitama Sekishinkai Hospital, 2-37-20 Irumagawa, Sayama, Saitama, 350-1305, Japan.
Surg Radiol Anat. 2023 Dec;45(12):1557-1561. doi: 10.1007/s00276-023-03247-z. Epub 2023 Oct 9.
To describe a case of a medial-type persistent trigeminal artery (PTA) associated with multiple arterial variations.
A 34-year-old woman with multiple sclerosis underwent cranial magnetic resonance (MR) angiography from the aortic arch to the neck region and intracranial region for the evaluation of an unruptured cerebral aneurysm that was previously detected on MR imaging. The MR machine was a 3-T scanner.
There was an aberrant right subclavian artery and bicarotid trunk, medial-type left PTA and ipsilateral posterior communicating artery (PCoA) supplying bilateral posterior cerebral arteries (PCAs). The unruptured aneurysm was located at the paraclinoid segment of the left internal carotid artery and was treated successfully by coil embolization via a transfemoral approach.
Only 10% of PTAs are classified as the medial type. The association with extremely large ipsilateral PCoA, which supplies the bilateral PCAs, has not been previously reported. Aberrant right subclavian arteries are common and are frequently associated with a bicarotid trunk. Before catheterization of the cerebral arteries, the aortic arch and its branches must be evaluated by MR angiography or computed tomography angiography to prevent catheterization failure via the right transradial approach.
描述一例与多种动脉变异相关的内侧型永存三叉动脉（PTA）。
一位 34 岁的多发性硬化症女性患者，因先前磁共振成像（MRI）检测到未破裂的脑动脉瘤，接受了从主动脉弓到颈部和颅内区域的颅磁共振血管造影术（MRA）检查。磁共振仪为 3T 扫描仪。
存在异常的右锁骨下动脉和双颈总动脉、左侧内侧型 PTA 和同侧后交通动脉（PCoA），为双侧大脑后动脉（PCA）供血。未破裂的动脉瘤位于左侧颈内动脉床突段，通过经股动脉途径成功进行了线圈栓塞治疗。
只有 10%的 PTA 被归类为内侧型。与供应双侧 PCA 的非常大的同侧 PCoA 相关的情况以前没有报道过。异常的右锁骨下动脉很常见，常与双颈总动脉相关。在进行大脑动脉导管插入术之前，必须通过 MRA 或 CT 血管造影术评估主动脉弓及其分支，以防止通过右侧经桡动脉途径导致导管插入术失败。
