Prevalence and Clinical Implications of the Primitive Trigeminal Artery and its Variants: A Meta-Analysis
| Autor: | Karolina Brzegowy, R. Shane Tubbs, Krzysztof A. Tomaszewski, Przemysław A. Pękala, Jakub R. Pękala, Marcin Mikos, Joyeeta Roy, Hasina M. Aziz, Michał P. Zarzecki, Jerzy A. Walocha |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Anastomosis Dorsum sellae 03 medical and health sciences 0302 clinical medicine Trigeminal neuralgia Cerebellum medicine.artery Prevalence medicine Basilar artery Humans Neuroradiology Central Nervous System Vascular Malformations Biological Variation Individual business.industry Intracranial Aneurysm Cerebral Arteries medicine.disease Anterior inferior cerebellar artery medicine.anatomical_structure Basilar Artery 030220 oncology & carcinogenesis Trigeminal artery Surgery Neurology (clinical) Radiology Internal carotid artery business Carotid Artery Internal 030217 neurology & neurosurgery |
| Zdroj: | World Neurosurgery. 133:e401-e411 |
| ISSN: | 1878-8750 |
| DOI: | 10.1016/j.wneu.2019.09.042 |
| Popis: | Background The primitive trigeminal artery (PTA) is the most common and the largest persistent carotid-basilar anastomosis. Primitive trigeminal artery variants (PTAVs) are anastomoses between the internal carotid artery and cerebellar arteries. These vessels pose a risk of hemorrhagic or ischemic complications during neurosurgical procedures in the parasellar and intrasellar regions. The aim of this study was to determine the prevalence of both PTA and PTAVs and their clinically important anatomic features. Methods Major electronic databases were thoroughly searched for studies on PTA and PTAV. References in the included articles were also evaluated. Data regarding prevalence, laterality, origin, course patterns, and associated anomalies were extracted and pooled into a meta-analysis. Results A total of 39 studies (110,866 patients) were included in the meta-analysis. The total pooled prevalence estimate of PTA and PTAVs combined was 0.4% (95% confidence interval [CI], 0.3–0.5). Individually, PTA was present in 0.3% of patients and PTAV in 0.2%. Both arteries most often originated from the C4 internal carotid artery and took a course lateral to the dorsum sellae. The anterior inferior cerebellar artery type was the predominant PTAV (72.1%). Basilar artery hypoplasia was found in 42.5% of patients with a PTA. Conclusions PTA and PTAVs are rare vessels, but they are clinically important because they can contribute to trigeminal neuralgia. Knowledge of the potential course of these arteries is essential in neuroradiology and neurosurgery, especially in minimally invasive procedures such as the endoscopic endonasal transsphenoidal approach to the pituitary gland and the percutaneous gasserian ganglion procedure. |
| Databáze: | OpenAIRE |
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