Özhan ÖZGÜR, Muzaffer SİNDEL, Timur SİNDEL, Güneş AYTAÇ

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

Persistence of fetal communications between the carotid and vertebrobasilar systems is uncommon. Persistent proatlantalartery is an anastomosis between the carotid and vertebrobasilar systems, typically classified as Type I and II. In this casereport, 600 angiographies are examined retrospectively and two persistent proatlantal arteries were observed - one withType 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.

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Vasović L, Mojsilović M, Andelković Z, Jovanović I, Arsić S, Vlajković S, Milenković Z. Proatlantal intersegmental artery: a review of normal and pathological features. Childs Nerv Syst 2009; 25:411–21.
Caldemeyer KS, Carrico JB, Mathews VP. The radiology and embryology of anomalous arteries of the head and neck. AJR Am J Roentgenol 1998;170:197–203.
Vasović L, Arsić S, Vlajković S, Jovanović I, Jovanović P, Ugrenović S, Andjelković Z. Otic artery: a review of normal and pathological features. Med Sci Monit 2010;16:Ra101–9.
Vasović L, Milenković Z, Jovanović I, Cukuranović R, Jovanović P, Stefanović I. Hypoglossal artery: a review of normal and pathological features. Neurosurg Rev 2008;31:385–95.
Ranchod AI, Gora G, Swartz RN, Andronikou S, Mngomezulu V. A rare carotid-basilar anastomosis traversing the jugular foramen: origin and clinical implications. Interv Neuroradiol 2011;17:347–50.
Bergman RA, Afifi AK, Miyauchi R. Persistent embryologic arteries (hyaloid, hypoglossal, stapedial, and trigeminal). Illustrated encyclopedia of human anatomic variation: opus ii: cardiovascular system: listing of the cardiovascular system.https://www.anatomyatlases.org/ AnatomicVariants/Cardiovascular/Directory/Region/ArteriesPersist ant.shtml [Retrieved April 1, 2018].
Tian Y, Wang YF, Du HG, Xu J, Zhang JM, Guo SX. 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;37:689–92.
Gumus T, Onal B, Ilgit ET. Bilateral persistence of type 1 proatlantal arteries: report of a case and review of the literature. AJNR Am J Neuroradiol 2004;25:1622–4.
Purkayastha S, Gupta AK, Varma R, Kapilamoorthy TR. Proatlantal intersegmental arteries of external carotid artery origin associated with Galen’s vein malformation. AJNR Am J Neuroradiol 2005;26: 2378–83.
Woodcock RJ, Cloft HJ, Dion JE. Bilateral type 1 proatlantal arteries with absence of vertebral arteries. AJNR Am J Neuroradiol 2001; 22:418–20.
Yilmaz E, Ilgit E, Taner D. Primitive persistent carotid-basilar and carotid-vertebral anastomoses: a report of seven cases and a review of the literature. Clin Anat 1995;8:36–43.
Arraez-Aybar LA, Navia-Alvarez P, Mendez-Cendon JC. A case of a type II proatlantal artery with arteriovenous malformation. Surg Radiol Anat 2011; 33:85–9.
Li TH, Lan MY, Liu JS, Tseng YL, Wu HS, Chang YY. Type II proatlantal intersegmental artery associated with objective pulsatile tinnitus. Neurology 2008;71:295–6.
Tubbs RS, Verma K, Riech S, Mortazavi MM, Shoja MM, Loukas M, Curé JK, Zurada A, Cohen-Gadol AA. Persistent fetal intracranial arteries: a comprehensive review of anatomical and clinical significance. J Neurosurg 2011;114:1127–34.
Zarghouni M, Marichal D. Persistent bilateral proatlantal type II artery. Proc (Bayl Univ Med Cent) 2013;26:50–1.
Montechiari M, Iadanza A, Falini A, Politi LS. 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: 863–5.
Bahfli YZ, Uysal H, Peker S, Yurdakul M. Persistent primitive proatlantal intersegmental artery (proatlantal artery I) results in ‘top of the basilar’ syndrome. Stroke 1993;24:2114–7.
Kolbinger R, Heindel W, Pawlik G, Erasmi-Körber H. 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;117:232–9.