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Persistent trigeminal artery detected on computed tomography angiography.

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Summary

Persistent trigeminal arteries (PTAs) were found in 0.6% of patients undergoing CT angiography. Accurate diagnosis of these vascular anomalies is vital to prevent complications during neurovascular procedures.

Keywords:
Blood vesselsCarotid–vertebrobasilar anastomosisComputed tomography angiographyPersistent trigeminal artery

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Area of Science:

  • Neurology
  • Radiology
  • Vascular Anatomy

Background:

  • Persistent trigeminal arteries (PTAs) are congenital vascular anomalies resulting from the persistence of the primitive trigeminal artery.
  • Their prevalence varies across studies, and understanding their anatomy is crucial for clinical practice.

Purpose of the Study:

  • To determine the prevalence of PTAs in a patient cohort using computed tomography (CT) angiography.
  • To describe the key characteristics of identified PTAs.
  • To compare these findings with existing literature.

Main Methods:

  • Retrospective analysis of cerebral CT angiography scans from December 2013 to December 2020.
  • Inclusion of 1150 patients, reviewing age, sex, and PTA presence.
  • Detailed examination of PTA localization, vascular connection, type (Saltzman/Salas classification), and associated pathologies.

Main Results:

  • Seven (0.6%) patients had PTAs out of 1150.
  • PTAs were more common on the left (57%) than the right (43%).
  • Classifications included Saltzman types I (43%), II (28%), III (28%) and Salas lateral (57%), medial (43%).

Conclusions:

  • Accurate diagnosis and classification of PTAs are essential for neuroradiologists and interventional physicians.
  • Undetected PTAs and associated vascular pathologies pose risks of fatal bleeding or embolism during procedures.
  • Awareness of PTA prevalence and characteristics aids in risk assessment and patient management.