Persistent carotid-vertebrobasilar anastomoses: cases of proatlantal artery Type I and Type II

Year 2018, Volume: 12 Issue: 2, 101 - 104, 15.08.2018

Özhan Özgür Güneş Aytaç , Muzaffer Sindel , Timur Sindel

Abstract

Persistence of fetal communications between the carotid and vertebrobasilar systems is uncommon. Persistent proatlantal

artery is an anastomosis between the carotid and vertebrobasilar systems, typically classified as Type I and II. In this case

report, 600 angiographies are examined retrospectively and two persistent proatlantal arteries were observed - one with

Type I (0.16%) and the other with Type II (0.16%) proatlantal artery. Existence of these arteries are associated with intracranial

vascular anomalies, especially aneurysms. In both of our cases, an aneurysm was detected in the middle cerebral artery.

Precise knowledge of these anastomoses is essential for intracranial operations and catheterizations performed in this region.

Keywords

angiography, carotid-vertebrobasilar anastomosis, persistent proatlantal artery

References

• 1. Vasovic, L., et al., Proatlantal intersegmental artery: a review of normal and pathological features. Childs Nervous System, 2009. 25(4): p. 411-421.
• 2. Caldemeyer, K.S., J.B. Carrico, and V.P. Mathews, The radiology and embryology of anomalous arteries of the head and neck. American Journal of Roentgenology, 1998. 170(1): p. 197-203.
• 3. Vasovic, L., et al., Otic artery: A review of normal and pathological features. Medical Science Monitor, 2010. 16(5): p. Ra101-Ra109.
• 4. Vasovic, L., et al., Hypoglossal artery: a review of normal and pathological features. Neurosurgical Review, 2008. 31(4): p. 385-395.
• 5. Ranchod, A.I., et al., A rare carotid-basilar anastomosis traversing the jugular foramen: origin and clinical implications. Interv Neuroradiol, 2011. 17(3): p. 347-50.
• 6. Bergman, A., R,, A. Afifi, and R. Miyauchi, Persistent Embryologic Arteries (Hyaloid, Hypoglossal, Stapedial, and Trigeminal), in Illustrated Encyclopedia of Human Anatomic Variation: Opus II: Cardiovascular System: Listing of the Cardiovascular System By Region, M. D'Alessandro, P, and A. Bergman, R,, Editors.
• 7. Tian, Y., et al., Left type I proatlantal artery with bilateral aberrant vertebral arteries and a ruptured aneurysm: a case report and review of the literature. Surg Radiol Anat, 2015. 37(6): p. 689-92.
• 8. Gumus, T., B. Onal, and E.T. Ilgit, Bilateral persistence of type 1 proatlantal arteries: report of a case and review of the literature. AJNR Am J Neuroradiol, 2004. 25(9): p. 1622-4.
• 9. Purkayastha, S., et al., Proatlantal intersegmental arteries of external carotid artery origin associated with Galen's vein malformation. American Journal of Neuroradiology, 2005. 26(9): p. 2378-2383.
• 10. Woodcock, R.J., H.J. Cloft, and J.E. Dion, Bilateral type 1 proatlantal arteries with absence of vertebral arteries. American Journal of Neuroradiology, 2001. 22(2): p. 418-420.
• 11. Yilmaz, E., E. Ilgit, and D. Taner, Primitive persistent carotid-basilar and carotid-vertebral anastomoses: a report of seven cases and a review of the literature. Clin Anat, 1995. 8(1): p. 36-43.
• 12. Arraez-Aybar, L.A., P. Navia-Alvarez, and J.C. Mendez-Cendon, A case of a type II proatlantal artery with arteriovenous malformation. Surg Radiol Anat, 2011. 33(1): p. 85-9.
• 13. Li, T.H., et al., Type II proatlantal intersegmental artery associated with objective pulsatile tinnitus. Neurology, 2008. 71(4): p. 295-6.
• 14. Tubbs, R.S., et al., Persistent fetal intracranial arteries: a comprehensive review of anatomical and clinical significance. Journal of Neurosurgery, 2011. 114(4): p. 1127-34.
• 15. Zarghouni, M. and D. Marichal, Persistent bilateral proatlantal type II artery. Proc (Bayl Univ Med Cent), 2013. 26(1): p. 50-1.
• 16. Montechiari, M., et al., Monolateral type I proatlantal artery with bilateral absence of vertebral arteries: description of a case and review of the literature. Surg Radiol Anat, 2013. 35(9): p. 863-5.
• 17. Bahsi, Y.Z., et al., Persistent primitive proatlantal intersegmental artery (proatlantal artery I) results in 'top of the basilar' syndrome. Stroke, 1993. 24(12): p. 2114-7.
• 18. Kolbinger, R., et al., Right proatlantal artery type I, right internal carotid occlusion, and left internal carotid stenosis: case report and review of the literature. J Neurol Sci, 1993. 117(1-2): p. 232-9.