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Classification of persistent primitive trigeminal artery (PPTA): a reconsideration based on MRA
Young Cheol Weon1, Seong Hoon Choi, Jae Cheol Hwang
1Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
Acta Radiologica (Stockholm, Sweden : 1987)
|October 5, 2011
Summary
Magnetic resonance angiography (MRA) is useful for detecting persistent primitive trigeminal artery (PPTA) variations. This study proposes a new classification system for PPTA based on its relationship with the basilar artery and PcomA.
Area of Science:
- Neurology
- Radiology
- Vascular Anatomy
Background:
- Persistent primitive trigeminal artery (PPTA) is the most common permanent carotid-basilar anastomosis.
- Magnetic resonance angiography (MRA) is a key non-invasive tool for evaluating cerebral vascular anatomy, offering detailed 3D imaging of intracranial vessels.
Purpose of the Study:
- To assess the utility of MRA in detecting PPTA.
- To re-classify PPTA variations based on embryologic types of the posterior communicating artery (PcomA) and its relationship with the basilar artery.
Main Methods:
- Retrospective analysis of MRA scans from 7329 patients, identifying 24 with PPTA.
- Detailed examination of PPTA's origin, size, course, and relationship with the basilar artery and PcomA.
- Classification of PPTA into five types based on anatomical relationships.
Main Results:
- PPTA was found in 0.33% of patients (24/7329).
- A new five-type classification was applied, with Type 1 being most common (45.8%).
- Associated findings included basilar artery hypoplasia (54%) and intracranial aneurysms (29%).
Conclusions:
- MRA is effective for PPTA detection and characterization.
- The proposed five-type classification system refines previous categorizations.
- Clinicians and radiologists should consider PPTA during MRA interpretation.
