Evaluation of the lenticulostriate arteries with rotational angiography and 3D reconstruction

Anatomic evaluation of the lenticulostriate arteries (LSAs) is important, especially in cases of surgical or endovascular treatment, but biplanar angiography provides limited information. We analyzed the LSAs with rotational angiography (RA) and 3D reconstruction and compared the findings with those of previous autopsy studies.

We retrospectively reviewed the LSAs on 3D reconstructed RA images (200 sides in 159 cases) to analyze their origin, course, and supplying territories. The angiographic configurations of the LSAs were classified by using the scheme devised by Yasargil.

LSAs from the anterior cerebral artery were demonstrated on 140 sides (70%). They originated from the A1 segment in 59 sides, from the A1-A2 junction on 41 sides, and from the A2 segment on 35 sides. They arose as a single trunk and ended as the most medial and anterior perforators in most cases. Arteries from the middle cerebral artery (MCA) were demonstrated on 190 sides (95%). They originated from the M1 segment on 131 sides, from the MCA bifurcation on 26 sides, and from the M2 segment on 33 sides; notably, all LSAs arising from the M2 segment originated from the superior division. In terms of configuration, we identified four major and 11 minor types. The most frequent LSA type was the combination of medial and lateral distal striate arteries, which comprised 53 sides (28%).

Analysis of LSAs with RA and 3D reconstructed images may provide useful information in patients with cerebrovascular diseases, especially before surgical and endovascular treatment.