Abstract
Purpose
To report an unusual case of combined Lie’s types A and D of internal carotid artery (ICA) agenesis, diagnosed by magnetic resonance angiography (MRA).
Methods
A 60-year-old woman with dizziness underwent cranial magnetic resonance imaging (MRI) and MRA of the intracranial region for the evaluation of brain and vascular lesions. The magnetic resonance machine was a 3.0-T scanner.
Results
MRI showed no abnormalities, except for multiple small white matter lesions. MRA showed that the left ICA was absent, except for the supraclinoid segment, and an anastomotic vessel was present between the paraclinoid segments of the bilateral ICAs, indicating Lie’s type D ICA agenesis. The left posterior communicating artery (PCoA) was also present. Thus, there were also features of type A ICA agenesis. The anastomotic vessels between the bilateral ICAs and ipsilateral PCoA were relatively small in caliber.
Conclusion
Lie’s type D ICA agenesis usually does not communicate with the anterior and posterior circulations. We encountered a case of combined type D and type A ICA agenesis. To our knowledge, no similar case has been reported in the English literature. This is the second case of type D ICA agenesis with patent ipsilateral PCoA. We speculate that in case of type A ICA agenesis, when the development of the PCoA is insufficient to support collateral blood flow, an anastomotic vessel between bilateral ICAs may develop.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data availability
No datasets were generated or analysed during the current study.
References
Bonasia S, Smajda S, Ciccio G, Bojanowski MW, Robert T (2023) Proposed new classification for internal carotid artery segmental agenesis based on embryologic and angiographic correlation. Surg Radiol Anat 45:375–387. https://doi.org/10.1007/s00276-023-03102-1
Chaudhary RK, Groskreutz D, Gupta E, Baghdadi Y, Smith S, Sapire J (2023) ICA agenesis with transcavernous anastomosis: a systematic review. Surg Radiol Anat 45:777–786. https://doi.org/10.1007/s00276-023-03117-8
Hong JH, Chang HW, Kim JM, Cho HC, Kim SH, Hong JH, Kim SJ, Jeong HW (2016) Internal carotid artery agenesis associated with a rare collateral pathway: supraclinoid-supraclinoid anastomosis. A case report. Surg Radiol Anat 38:261–263. https://doi.org/10.1007/s00276-015-1531-7
Lasjaunias P, Santoyo-Vazquez A A (1984) Segmental agenesis of the internal carotid artery: angiographic aspects with embryological discussion. Anat Clin 6:133–141. https://doi.org/10.1007/BF01773165
Lie TA (1968) The congenital anomalies of the carotid arteries. Excerpta Medica Foundation, Amsterdam, New York, pp 35–51
Okawa M, Higashi T, Komiyama M, Fukuda K, Abe H, Inoue T (2015) Left internal carotid artery agenesis with trans-sellar collateral and a right aortic arch: Case report. Interv Neuroradiol 21:759–764. https://doi.org/10.1177/1591019915609130
Oz II, Serifoglu I, Yazgan O, Erdem R (2016) Congenital absence of internal carotid artery with intercavernous anastomosis: case report and systematic review of the literature. Interv Neuroradiol 22:473–480. https://doi.org/10.1177/1591019916641317
Padget DH (1948) The development of cranial arteries in the human embryo. Contrib Embryol 32:205–262
Park YW, Yoo J, Kim DJ (2018) Double inter-internal carotid artery communication through intercavernous anastomosis and posterior communicating artery associated with multiple intracranial artery segmental agenesis/aplasia. Surg Radiol Anat 40:227–231. https://doi.org/10.1007/s00276-017-1897-9
Uchino A, Saito N, Kohyama S (2015) Agenesis of the internal carotid artery with paraclinoid-supraclinoid anastomosis and basilar artery-posterior communicating artery anastomosis diagnosed by magnetic resonance angiography. Surg Radiol Anat 37:685–687. https://doi.org/10.1007/s00276-014-1388-1
Yamashita K, Yasaka M, Uchino A, Noguchi T (2022) Unilateral agenesis of internal carotid artery with interparaclinoid and contralateral carotid-anterior cerebral artery anastomoses diagnosed by magnetic resonance angiography: a case report. Surg Radiol Anat 44:289–292. https://doi.org/10.1007/s00276-021-02844-0
Zhang P, Wang Z, Yu FX, Lv H, Liu XH, Feng WH, Ma J, Yang ZH, Wang ZC (2018) The clinical presentation and collateral pathway development of congenital absence of the internal carotid artery. J Vasc Surg 68:1054–1061. https://doi.org/10.1016/j.jvs.2018.01.043
Funding
The authors did not receive support from any organization for the submitted work.
Author information
Authors and Affiliations
Contributions
TM and AU carried out the study design and drafted the manuscript. TM, AU, MS, KM and YB reviewed the manuscript critically, and have read and approved the final manuscript.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare no competing interests.
Ethical approval and consent to participate
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
Consent for publication
The patient gave her written informed consent regarding publishing her data and associated figures.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Maki, T., Uchino, A., Sugiyama, M. et al. Combined lie’s type D and type A agenesis of the left internal carotid artery diagnosed by magnetic resonance angiography. Surg Radiol Anat (2024). https://doi.org/10.1007/s00276-024-03366-1
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s00276-024-03366-1