Clinical Importance of the Persistent Primitive Trigeminal Artery in Vascular Lesions and Its Role in Endovascular Treatment

Overview

Journal Front Neurol

Specialty Neurology

Date 2022 Jul 28

PMID 35899260

Authors

YiHeng Wang

Jinlu Yu

Affiliations

Soon will be listed here.

Abstract

The persistent primitive trigeminal artery (PPTA) extends from the internal carotid artery to the basilar artery between the origins of the anterior inferior cerebellar artery and superior cerebellar artery. PPTAs have complex anatomical characteristics. Salas and Saltzman classifications are most often used in PPTAs. The PPTA can play many roles in vascular lesions, including intracranial aneurysms, brain arteriovenous malformations, trigeminal artery-cavernous fistulas, Moyamoya disease, and large vessel occlusion. For these lesions, surgical treatment is difficult due to the deep location and complex anatomy of the PPTA, but endovascular treatment (EVT) has emerged as a good alternative. Currently, a complete review of the clinical importance of the PPTA in terms of its role in the development and EVT of vascular lesions is lacking. Therefore, we conducted a PubMed search, performed a review of the relevant extracted literature and cataloged our experience with PPTAs. By review, we found that a thorough understanding of the anatomical and angiographic features of this PPTA is of utmost importance when making therapeutic decisions for any of these pathological conditions.

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References

Meckel S, Spittau B, McAuliffe W . The persistent trigeminal artery: development, imaging anatomy, variants, and associated vascular pathologies. Neuroradiology. 2011; 55(1):5-16. DOI: 10.1007/s00234-011-0995-3. View

Uchino A, Sawada A, Takase Y, Kudo S, Koizumi T . Moyamoya disease associated with an anterior inferior cerebellar artery arising from a persistent trigeminal artery. Eur Radiol. 2003; 12 Suppl 3:S14-7. DOI: 10.1007/s00330-002-1416-0. View

Ohtakara K, Kuga Y, Murao K, Kojima T, Taki W, Waga S . Posterior fossa arteriovenous malformation associated with persistent primitive trigeminal artery--case report. Neurol Med Chir (Tokyo). 2000; 40(3):169-72. DOI: 10.2176/nmc.40.169. View

Aguiar G, Conti M, Veiga J, Jory M, Souza R . Basilar artery aneurysm at a persistent trigeminal artery junction. A case report and literature review. Interv Neuroradiol. 2011; 17(3):343-6. PMC: 3396038. DOI: 10.1177/159101991101700310. View

Uchino A, Saito N, Takahashi M, Kurita H, Ishihara S . Cerebral Arterial Variations Associated with Moyamoya Disease Diagnosed by MR Angiography. Neuroradiol J. 2014; 27(6):697-701. PMC: 4291787. DOI: 10.15274/NRJ-2014-10093. View

Uchino A, Ohno H, Kondo R, Ishihara S . Medial type persistent trigeminal artery associated with a saccular aneurysm at its trunk. Surg Radiol Anat. 2021; 43(3):433-436. DOI: 10.1007/s00276-020-02656-8. View

Horio Y, Fukuda K, Yoshinaga T, Takeyama R, Fukumoto H, Sato K . Successful mechanical thrombectomy using a combined technique for internal carotid artery occlusion with persistent primitive trigeminal artery. Surg Neurol Int. 2020; 11:345. PMC: 7656013. DOI: 10.25259/SNI_657_2020. View

Shigemori M, Shirahama M, Yamamoto F, Hara K, Tokutomi T, Nakashima O . Primitive trigeminal artery and intracranial carotid occlusion--a case report. Kurume Med J. 1980; 27(4):263-8. DOI: 10.2739/kurumemedj.27.263. View

Zenteno M, Lee A, Moscote-Salazar L . Rupture of Persistent Primitive Trigeminal Artery-basilar Artery Aneurysm Managed with Stent-assisted Coiling. Asian J Neurosurg. 2018; 13(3):817-821. PMC: 6159046. DOI: 10.4103/ajns.AJNS_53_16. View

10.

Greenway M, Yacoub H, Varade S, Isayev Y . Carotid Endarterectomy in a Patient with Severe Internal Carotid Artery Stenosis with Persistent Trigeminal Artery and Ischemia of the Anterior and Posterior Circulation. Case Rep Neurol Med. 2018; 2017:7193734. PMC: 5733951. DOI: 10.1155/2017/7193734. View

11.

Mariani L, Klein I, Pico F . Hypoplasia or stenosis: Usefulness of high-resolution MRI. Rev Neurol (Paris). 2011; 167(8-9):619-21. DOI: 10.1016/j.neurol.2011.01.003. View

12.

Purkayastha S . Persistent trigeminal artery with bilateral ophthalmoplegia and contralateral internal carotid artery occlusion. A case report. Neuroradiol J. 2013; 21(3):401-5. DOI: 10.1177/197140090802100317. View

13.

Lyu D, Wang Y, Wang K, Yao M, Wu Y, Zhou Z . Acute Cerebral Infarction in a Patient with Persistent Trigeminal Artery and Homolateral Hypoplasia of Internal Carotid Artery Distal Anastomosis: A Case Report and a Mini Review of the Literature. J Stroke Cerebrovasc Dis. 2019; 28(12):104388. DOI: 10.1016/j.jstrokecerebrovasdis.2019.104388. View

14.

Nunes M, Ullah A, Rios J, Garg A . Persistent Trigeminal Artery Playing a Protective Role in a Case of Vertebral Artery Dissection and Stenosis. Cureus. 2019; 11(8):e5327. PMC: 6777932. DOI: 10.7759/cureus.5327. View

15.

Foerch C, Berkefeld J, Halbsguth A, Ziemann U, Neumann-Haefelin T . Brain stem infarction caused by proximal internal carotid artery stenosis in a patient with a persisting primitive trigeminal artery. Cerebrovasc Dis. 2006; 22(2-3):200-2. DOI: 10.1159/000093808. View

16.

Chen S, Liu Y . Moyamoya disease associated with bilateral persistent primitive trigeminal arteries: report of a case. J Formos Med Assoc. 1993; 92(4):385-7. View

17.

Chen W, Tsai T, Shen S, Shen C, Tsuei Y . A Case of Giant Thrombosed Persistent Primitive Trigeminal Artery Aneurysm Presenting with Trigeminal Neuralgia and Successfully Treated by a Covered Stent: Case Report and Review of Literature. Clin Neuroradiol. 2014; 25(2):207-10. DOI: 10.1007/s00062-014-0314-6. View

18.

Iancu D, Anxionnat R, Bracard S . Brainstem infarction in a patient with internal carotid dissection and persistent trigeminal artery: a case report. BMC Med Imaging. 2010; 10:14. PMC: 2908053. DOI: 10.1186/1471-2342-10-14. View

19.

Oran I, Parildar M, Memis A, Yunten N . Catheter and MR angiography of persistent trigeminal artery associated with occipital arteriovenous malformation. Comput Med Imaging Graph. 2000; 24(1):33-5. DOI: 10.1016/s0895-6111(99)00040-3. View

20.

Masaryk T, Perl 2nd J, Wallace R, Magdinec M, Chyatte D . Detachable balloon embolization: concomitant use of a second safety balloon. AJNR Am J Neuroradiol. 1999; 20(6):1103-6. PMC: 7056223. View