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ICA agenesis with transcavernous anastomosis: a systematic review
Ranjit Kumar Chaudhary1, Derek Groskreutz2, Elina Gupta1
1St. Vincent's Medical Center, Bridgeport, CT, USA.
Surgical and Radiologic Anatomy : SRA
|March 10, 2023
Summary
Internal Carotid Artery (ICA) agenesis with type D collateral is a rare condition. This anomaly increases the risk of aneurysms and can mimic other conditions, necessitating careful patient management.
Area of Science:
- Neurology
- Vascular Surgery
- Radiology
Background:
- Internal Carotid Artery (ICA) agenesis is a rare congenital anomaly.
- Understanding its associations with other vascular anomalies and intracranial aneurysms is crucial for clinical management.
Approach:
- A systematic review of MEDLINE was conducted for cases of ICA agenesis with intercavernous anastomosis.
- Two additional cases of ICA agenesis with type D collateral were included.
- Search terms included "internal carotid artery", "agenesis", and "transcavernous anastomosis".
Key Points:
- Fifty patients with ICA agenesis were analyzed from 46 studies and two new cases.
- Collateral vessels were predominantly located on the floor of the sella, often connecting to cavernous ICA segments.
- Aneurysms were present in over 25% of patients, and the condition can mimic pituitary microadenoma.
Conclusions:
- ICA agenesis with type D collateral is a rare but clinically significant anomaly.
- Associated risks include intracranial aneurysms and misdiagnosis as pituitary microadenoma.
- Awareness of this variant aids in appropriate patient management and avoids misinterpretation of imaging findings.
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