Coil embolisation of multiple cerebral aneurysms with lateral type I persistent primitive trigeminal artery: A case report and literature review

Interv Neuroradiol. 2019 Dec;25(6):628-634. doi: 10.1177/1591019919859507. Epub 2019 Jun 20.

Abstract

The primitive trigeminal artery is an anastomotic vessel of the carotid-basilar artery system that occurs only transiently during the embryonic period. Persistent primitive trigeminal artery occurs in approximately 0.1-0.6% of the population. Here, we report the case of a 60-year-old woman with Fisher II grade subarachnoid haemorrhage. Computed tomography angiography demonstrated a lateral, Saltzman type I persistent primitive trigeminal artery with three cerebral aneurysms, including one anterior communicating artery aneurysm, one suspicious right anterior choroidal artery aneurysm and one distal basilar artery aneurysm supplied by the persistent primitive trigeminal artery. All three aneurysms were treated with coil embolisation. At the 8-month follow-up, the anterior communicating artery aneurysm had a neck remnant, the other two aneurysms exhibited complete occlusion. Persistent primitive trigeminal artery with multiple cerebral aneurysms is extremely rare, and only seven cases of persistent primitive trigeminal artery with multiple cerebral aneurysms have previously been reported in publications that included information on treatment. Most aneurysms were treated by open surgery. This is the first report of coil embolisation treatment of multiple aneurysms in persistent primitive trigeminal artery patients with follow-up results, and provides relevant and valuable information about the persistent primitive trigeminal artery and the endovascular treatment of multiple aneurysms in persistent primitive trigeminal artery patients.

Keywords: Persistent primitive trigeminal artery; coil embolisation; multiple aneurysms.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Angiography, Digital Subtraction
  • Cerebral Angiography
  • Cerebral Arteries / abnormalities*
  • Computed Tomography Angiography
  • Embolization, Therapeutic / methods*
  • Female
  • Humans
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Aneurysm / therapy*
  • Middle Aged
  • Tomography, X-Ray Computed