title: Thrombectomy in posterior circulation stroke through persistent primitive trigeminal artery: A case report.
abstract: We describe a case of intra-arterial treatment (IAT) of acute posterior circulation occlusion in a patient with a persistent primitive trigeminal artery (PPTA). The patient presented with an acute left sided hemiparesis and loss of consciousness (Glasgow coma score of 5). Computed tomography angiography showed an acute occlusion of the right internal carotid artery (ICA), the PPTA, distal basilar artery (BA), right posterior cerebral artery (PCA), and right superior cerebellar artery (SCA). Stent-retriever assisted thrombectomy was not considered possible through the hypoplastic proximal BA. After passage of the proximal ICA occlusion, the right PCA and SCA were recanalized through the PPTA, with a single thrombectomy procedure. Ten days after intervention patient was discharged scoring optimal EMV with only a mild facial and left hand paresis remaining. PPTA is a persistent embryological carotid-basilar connection. Knowledge of existing (embryonic) variants in neurovascular anatomy is essential when planning and performing acute neurointerventional procedures.
authors.affiliation: Department of Neurology, Erasmus MC University Medical Center Rotterdam, the Netherlands m.mulder@erasmusmc.nl.
authors.forename: Mjhl
authors.initials: M
authors.lastname: Mulder
authors.affiliation: Department of Radiology, Medisch Centrum Haaglanden, The Hague, the Netherlands.
authors.forename: G J
authors.initials: GJ
authors.lastname: Lycklama À Nijeholt
authors.affiliation: Department of Radiology, Erasmus MC University Medical Center Rotterdam, the Netherlands.
authors.forename: W
authors.initials: W
authors.lastname: Dinkelaar
authors.affiliation: Department of Radiology, Medisch Centrum Haaglanden, The Hague, the Netherlands.
authors.forename: Tpw
authors.initials: T
authors.lastname: de Rooij
authors.affiliation: Department of Radiology, Medisch Centrum Haaglanden, The Hague, the Netherlands.
authors.forename: Acgm
authors.initials: A
authors.lastname: van Es
authors.affiliation: Department of Radiology, Medisch Centrum Haaglanden, The Hague, the Netherlands.
authors.forename: B F
authors.initials: BF
authors.lastname: van der Kallen
authors.affiliation: Department of Radiology, Erasmus MC University Medical Center Rotterdam, the Netherlands.
authors.forename: B J
authors.initials: BJ
authors.lastname: Emmer
mesh_terms: D000368:Aged; D001488:Basilar Artery; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D002343:Carotid Artery, Internal; D002533:Cerebral Angiography; D000072226:Computed Tomography Angiography; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging*; D008297:Male; D020769:Posterior Cerebral Artery; D020521:Stroke / Q000000981:diagnostic imaging / Q000601:surgery*; D017131:Thrombectomy / Q000379:methods*
keywords: Cerebrovascular disease; intra-arterial treatment; trigeminal artery