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Persistent trigeminal artery: a cross-sectional study based on over 3 years conventional angiography, CT angiography and MR angiography images

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Abstract

Purpose

The trigeminal artery is one of the four primitive anastomosis established between the internal carotid artery and the vertebrobasilar system that regresses at the sixth week of embryonic development. Its persistence in adult life (PTA) is usually found incidentally. The aim of this study is to determine its prevalence, main characteristics and clinical significance.

Methods

A cross-sectional study was performed over the last 3 years, 2012–2014, to analyze images performed on conventional angiography, CT angiography and MR angiography of patients who attended the Neuroradiology Department of the Hospital Universitario Doce de Octubre in Madrid, Spain, to control their underlying pathology.

Results

Nine cases of PTA were found (prevalence 0.37 %, two men, seven women; three right, six left; age range 13–88 years). Eight PTA emerged from the cavernous ICA and one from the petrous segment. Six cases were lateral or petrosal type and one was medial or sphenoidal type. The whole PTAs anastomosed the BA, six at the middle third and three at the distal third. Weon et al.’s type 3 was predominant. CVD incidence was 55.6 % and aneurysm incidence was 22 %.

Conclusions

PTA prevalence was similar to those previously reported, being commonly left-sided, Salas et al.’s lateral or petrosal type, Weon et al.’s type 3 and with no gender predominance. CVD and aneurysms incidence in the presence of a PTA were higher than in general population. Its anatomical relations make it essential to consider its presence and directional blood flow when planning endovascular and neurosurgical treatments.

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Abbreviations

ACA:

Anterior cerebral artery

AComA:

Anterior communicating artery

AICA:

Anterior inferior cerebellar artery

BA:

Basilar artery

CA:

Conventional angiography

CRL:

Craneo-rostral length

CT angiography:

Computerized tomography angiography

CVD:

Cerebrovascular disease

HA:

Hypoglossal artery

ICA:

Internal carotid artery

LNA:

Longitudinal neural artery

MR angiography:

Magnetic resonance angiography

OA:

Otic artery

PCA:

Posterior cerebral artery

PComA:

Posterior communicating artery

PICA:

Posterior inferior cerebellar artery

PTA:

Persistent trigeminal artery

SCA:

Superior cerebellar artery

TA:

Trigeminal artery

TIA:

Transient ischemic attack

VA:

Vascular anomalies

VeA:

Vertebral artery

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Acknowledgments

The authors thank Mrs. Ana-Mª Álvarez-Castrosín for her assistance in the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Human Anatomy and Embryology, Faculty of Medicine, University Complutense, Ciudad Universitaria s/n, 28040, Madrid, Spain

    Luis-Alfonso Arráez-Aybar

  2. Institute of Morphofunctional Sciences, Madrid Complutense University, Madrid, Spain

    Luis-Alfonso Arráez-Aybar & Talia Fuentes-Redondo

  3. Neuroradiology Unit, Department of Radiology, Hospital Doce de Octubre, Madrid, Spain

    José M. Millán

Authors
  1. Luis-Alfonso Arráez-Aybar
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  2. Talia Fuentes-Redondo
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  3. José M. Millán
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Corresponding author

Correspondence to Luis-Alfonso Arráez-Aybar.

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The authors declare that they have no conflict of interest.

Ethical standards

This study was approved by the Ethical Committee of the Hospital Clínico ‘San Carlos’, Madrid, Spain (12/318-E).

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Arráez-Aybar, LA., Fuentes-Redondo, T. & Millán, J.M. Persistent trigeminal artery: a cross-sectional study based on over 3 years conventional angiography, CT angiography and MR angiography images. Surg Radiol Anat 38, 445–453 (2016). https://doi.org/10.1007/s00276-015-1578-5

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  • DOI: https://doi.org/10.1007/s00276-015-1578-5

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