[Stenting for cerebral infarction due to stenosis of a persistent primitive proatlantal artery: a case report]

Cerebrovascular disorders complicated by persistent primitive arteries are commonly reported, but, we herein present a 78-year-old man with cerebral infarction due to stenosis of a persistent primitive artery by itself. Cerebral angiography revealed bilateral vertebral artery aplasia to be complicated by a persistent primitive proatlantal artery which had become an important collateral circulation pathway. While the patient was hospitalized because of mild sensory impairment, he also developed visual field constriction and cerebellar symptoms due to recurrent stroke despite anticoagulation treatment. Based on the results of various examinations, cerebral embolism, probably caused by stenosis at the origin of the persistent proatlantal artery, was diagnosed. Carotid artery stenting for the stenosis was planned. A filter protection device was found to be very useful for stenting with maintenance of blood flow in the persistent primitive proatlantal artery. There have been no reports of stenting in persistent primitive proatlantal arteries, such as that our present case is considers. It provides valuable information on the management of this rare disorder.