Persistent carotid-vertebrobasilar anastomoses
Citation, DOI, disclosures and article data
At the time the article was created Haris Sair had no recorded disclosures.
View Haris Sair's current disclosuresAt the time the article was last revised Craig Hacking had the following disclosures:
- Philips Australia, Paid speaker at Philips Spectral CT events (ongoing)
These were assessed during peer review and were determined to not be relevant to the changes that were made.
View Craig Hacking's current disclosures- Persistent Carotid-Vertebrobasilar Anastomoses
- Persistent carotid-basilar artery anastomosis
The persistent carotid-vertebrobasilar anastomoses are variant anatomical arterial communications between the anterior and posterior circulations due to abnormal embryological development of the vertebrobasilar system. They are named, with the exception of the proatlantal artery, using the cranial nerves with which they run:
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arises from proximal cavernous ICA
most common persistent carotid-vertebrobasilar anastomosis
two types - lateral and medial
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Saltzman classification
type I: PPTA supplies the distal vertebrobasilar arteries. The posterior communicating artery is absent and the caudal basilar is absent or hypoplastic with hypoplastic distal vertebral arteries.
type II: PPTA supplies the superior cerebellar arteries with the posterior cerebral arteries supplied by the posterior communicating artery
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type III: PPTA does not join the basilar artery, instead directly terminating as the:
type IIIa: superior cerebellar artery
type IIIb: anterior inferior cerebellar artery
type IIIc: posterior inferior cerebellar artery
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persistent otic (acoustic) artery
controversial, perhaps non-existent
arises from petrous ICA
rare, as it is the first anastomosis to regress
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arises from cervical ICA at C1 to C3 levels
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type I arises from internal carotid artery
type II arises from external carotid artery
A mnemonic to help remember these persistent carotid-vertebrobasilar anastomoses is HOT Pepper.
Quiz questions
References
- 1. Uchino A, Sawada A, Takase Y et-al. MR angiography of anomalous branches of the internal carotid artery. AJR Am J Roentgenol. 2003;181 (5): 1409-14. AJR Am J Roentgenol (full text) - Pubmed citation
- 2. Luh GY, Dean BL, Tomsick TA et-al. The persistent fetal carotid-vertebrobasilar anastomoses. AJR Am J Roentgenol. 1999;172 (5): 1427-32. AJR Am J Roentgenol (citation) - Pubmed citation
- 3. Basekim CC, Silit E, Mutlu H et-al. Type I proatlantal artery with bilateral absence of the external carotid arteries. AJNR Am J Neuroradiol. 2004;25 (9): 1619-21. AJNR Am J Neuroradiol (full text) - Pubmed citation
- 4. Dimmick SJ, Faulder KC. Normal variants of the cerebral circulation at multidetector CT angiography. Radiographics. 2009;29 (4): 1027-43. Radiographics (full text) - doi:10.1148/rg.294085730 - Pubmed citation
Incoming Links
- Internal carotid artery
- Persistent hypoglossal artery
- Basilar artery
- Persistent otic artery
- Persistent proatlantal intersegmental artery
- Basilar artery hypoplasia
- Proatlantal artery
- Persistent primitive trigeminal artery
- Posterior cerebral circulation
- Circle of Willis
- Intracranial arteries (variants)
- Persistent communications between the carotid and vertebrobasilar arteries (mnemonic)
- Primitive arteries in the brain (mnemonic)
- Persistent carotid-vertebrobasilar anastomoses
- Persistent trigeminal artery
- Persistent hypoglossal artery
- Basilar artery hypoplasia
- Persistent hypoglossal artery and bovine arch
- Persistent trigeminal artery
- Type II proatlantal artery
- Persistent hypoglossal artery
- Persistent trigeminal artery
- Persistent primitive trigeminal artery (Saltzman I)
- Persistent trigeminal artery
- Proatlantal intersegmental artery
- Trigeminal artery and basilar ectasia
- Primitive trigeminal artery with fetal PCOM
- Pineal cyst and trigeminal artery
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