Relevance of Primitive Carotidobasilar Anastomosis for Internal Carotid Artery Stenosis

• Authors: Andrej Udelnow , Michael Goertler , Frank Meyer , Zuhir Halloul
• Languages of publication: EN

Abstracts

EN

Primitive carotido-basilar anastomoses (PCA) are persistent fetal vessels. The aim of the study was to compare the clinical characteristics of patients operated on for internal carotid artery (ICA) stenosis with or without PCA in order to evaluate the impact of PCA on the treatment. Material and methods. Consecutive patients operated on for ICA stenosis at our university hospital were included. Surgical treatment consisted in carotid endarterectomy (CEA) with patch plastic. Results. Of the 380 CEA performed between 2006 and 2012, PCA were found in six patients (1.6%). All patients with PCA were symptomatic vs. 54% of patients without PCA (p=0.035). Significantly less posterior collateral flow was present in patients with PCA (33%) compared to those without PCA (85%, p=0.01). Only two of the six patients with PCA were diagnosed prior to surgery, none was ligated intraoperatively. PCA was not associated with stroke and restenosis at long-term follow up. Conclusions. PCA are rarely diagnosed prior to surgery in patients with ICA stenosis and need not to be ligated during CEA

Keywords

EN

internal crotid artery stenosis; primitive carotidobasilar anastomosis

• Publisher: De Gruyter Open
• Journal: Polish Journal of Surgery
• Year: 2015
• Volume: 86
• Issue: 4
• Pages: 166-171

Dates

published

1 - 4 - 2014

online

27 - 6 - 2014

received

3 - 9 - 2014

Contributors

author

Andrej Udelnow

• Magdeburg University Hospital, Division of Vascular Surgery, Department of Surgery, Germany

author

Michael Goertler

• Magdeburg University Hospital, Department of Neurology, Germany

author

Frank Meyer

• Magdeburg University Hospital, Department of General and Abdominal Surgery, Germany

author

Zuhir Halloul

• Magdeburg University Hospital, Division of Vascular Surgery, Department of Surgery, Germany

References

• 1. Pulli R, Gatti M, Pratesi C: Carotid endarterectomy in rare bilateral carotid-vertebral anastomosis. J Vasc Surg 2001; 33(5): 1122-24.[Crossref][PubMed]
• 2. Schoof J, Skalej M, Halloul Z, Wunderlich MT: Carotid endarterectomy in a patient with persistent proatlantal artery. Cerebrovasc Dis 2007; 23(5-6): 458-59.[Crossref][WoS]
• 3. O’uchi E, O’uchi T: Persistent primitive trigeminal arteries (pta) and its variant (ptav): analysis of 103 cases detected in 16,415 cases of mra over 3 years. Neuroradiology 2010; 52(12): 1111-19.[WoS]
• 4. Komiyama M, Nakajima H, Nishikawa M et al.: High incidence of persistent primitive arteries in moyamoya and quasi-moyamoya diseases. Neurol Med Chir (Tokyo), 1999; 39(6): 416-20; discussion 420-22.[Crossref]
• 5. Matsui H, Udaka F, Kubori T et al.: Persistent primitive hypoglossal artery with atrial septal defect. Intern Med 2005; 44(5): 507-08.[PubMed][Crossref]
• 6. Hess CP, Fullerton HJ, Metry DW et al.: Cervical and intracranial arterial anomalies in 70 patients with phace syndrome. AJNR Am J Neuroradiol 2010; 31(10):1980-86.[PubMed][Crossref]
• 7. Yamamoto T, Hasegawa Y, Ohmori Y et al.: Ruptured cerebral aneurysm associated with a per- sistent primitive trigeminal artery variant. Surg Neurol Int 2011; 2: 126.
• 8. Pereira LP, Nepomuceno LAM, Coimbra PP et al.: Persistent trigeminal artery: angio-tomography and angio-magnetic resonance finding. Arq Neuropsiquiatr 2009; 67(3B): 882-85.[PubMed][Crossref]
• 9. Schwartz NE, Albers GW: Acute strokes in the setting of a persistent primitive trigeminal artery. BMJ Case Rep 2009; 2009: bcr2006111773.
• 10. Grego F, Stramanà R, Lepidi S et al.: Primitive proatlantal intersegmental artery and carotid endarterectomy. J Vasc Surg 2004; 39(3): 691.[Crossref][PubMed]
• 11. R Development Core Team. R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing, Vienna, Austria, 2010. ISBN 3-900051-07-0.
• 12. Weon YC, Choi SH, Hwang JC et al.: Classification of persistent primitive trigeminal artery (ppta): a reconsideration based on mra. Acta Radiol 2011; 52(9): 1043-51.[WoS][PubMed][Crossref]
• 13. Vlychou M, Georganas M, Spanomichos G et al.: Zavras. Angiographic findings and clinical implications of persistent primitive hypoglossal artery. BMC Med Imaging 2003; 3(1): 2. [PubMed][Crossref]

Identifiers

DOI

10.2478/pjs-2014-0030