1
|
Bonnet B, Shotar E, Premat K, Cormier E, Beth A, Trebern H, Mahtout J, Feydy A, Clarençon F. Percutaneous alcohol embolization and vertebroplasty of a T2 aggressive vertebral hemangioma with prior embolization of dangerous arterial anastomoses. J Neurointerv Surg 2022:jnis-2022-019036. [PMID: 35835464 DOI: 10.1136/jnis-2022-019036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/25/2022] [Indexed: 11/03/2022]
Abstract
Aggressive vertebral hemangiomas usually exhibit extraosseous expansion that can result in spinal cord or radicular compression.1 In symptomatic cases, treatment by alcohol embolization and percutaneous vertebroplasty has been reported as feasible, safe, and effective with long-term benefits on neurological symptoms.2 Safety rules before vertebral alcohol embolization include preoperative spinal cord vascularization mapping and opacification through bone needles to assess the absence of dangerous intratumoral anastomoses.In video 1 we present a case of a symptomatic T2 aggressive vertebral hemangioma with dangerous anastomoses between the lesion and both supreme intercostal arteries (SIAs). Embolization by the arterial route of both SIAs was performed, which required good anatomic knowledge of the spinal cord vascularization at the cervicothoracic junction3 4 as a cervical radiculomedullary artery arose from the left costocervical trunk which also fed the left SIA. After occlusion of all dangerous arterial anastomoses, we were able to successfully perform T2 alcohol embolization and percutaneous vertebroplasty. neurintsurg;jnis-2022-019036v1/V1F1V1Video 1Case presentation.
Collapse
Affiliation(s)
- Baptiste Bonnet
- Neuroradiology, APHP Sorbonne University. Pitié-Salpêtrière Hospital, Paris, France
| | - Eimad Shotar
- Neuroradiology, APHP Sorbonne University. Pitié-Salpêtrière Hospital, Paris, France
| | - Kevin Premat
- Neuroradiology, APHP Sorbonne University. Pitié-Salpêtrière Hospital, Paris, France
| | - Evelyne Cormier
- Neuroradiology, APHP Sorbonne University. Pitié-Salpêtrière Hospital, Paris, France
| | - Adrien Beth
- Neuroradiology, APHP Sorbonne University. Pitié-Salpêtrière Hospital, Paris, France
| | - Hugo Trebern
- Neuroradiology, APHP Sorbonne University. Pitié-Salpêtrière Hospital, Paris, France
| | - Jugurtha Mahtout
- Anesthesiology, APHP Sorbonne University. Pitié-Salpêtrière Hospital, Paris, France
| | | | - Frédéric Clarençon
- Neuroradiology, APHP Sorbonne University. Pitié-Salpêtrière Hospital, Paris, France
| |
Collapse
|
2
|
Martín-González I, Díez-Solórzano ML, Blasco-Serra A, Valverde-Navarro AA, Colás-López A, Linuesa-Mendoza M, Cortés-Aucejo JJ, Ekuaga-Eyang MM, Jara-Jaquez A, Cortés-Martínez MC. Bilateral vertebral arteries arising distal to the left subclavian artery: embryological and anatomical description. Surg Radiol Anat 2022; 44:531-534. [PMID: 35266028 DOI: 10.1007/s00276-022-02903-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 02/11/2022] [Indexed: 11/24/2022]
Abstract
Abnormalities in the origin of vertebral arteries are relatively uncommon, but extremely rare when this abnormality happens on both sides. We present an anatomic variation in which both vertebral arteries came from the proximal descending thoracic aorta beyond the left subclavian artery with no other supra-aortic vessels accompanying the abnormality. The right vertebral artery took a retro-oesophageal course (lusoria artery), while the right and the left vertebral arteries enter the transverse foramina at the 7th cervical vertebra. From an embryological point of view, and overall controversial, this anomaly can be explained by the bilateral persistence of the 8th intersegmental artery as the origin of vertebral artery, instead of the dorsal segment of the 7th intersegmental artery being the origin, which is normally the case. The adequate identification of vertebral artery anomalies in complementary explorations is very important to avoid misdiagnosed vertebral occlusions or unexpected vertebral artery injuries during supra-aortic trunks, thyroid, and oesophagus open surgeries, among others, or even over the course of endovascular procedures.
Collapse
Affiliation(s)
- Iván Martín-González
- Cardiovascular Surgery Department, Hospital Universitari i Politècnic La Fe, Av/Fernando Abril Martorell, 106, 46026, Valencia, Spain.,Department of Surgery, University of Valencia, Valencia, Spain
| | - María Lorena Díez-Solórzano
- Cardiovascular Surgery Department, Hospital Universitari i Politècnic La Fe, Av/Fernando Abril Martorell, 106, 46026, Valencia, Spain. .,Department of Surgery, University of Valencia, Valencia, Spain.
| | - Arantxa Blasco-Serra
- Department of Human Anatomy and Embryology, University of Valencia, Valencia, Spain
| | | | | | | | | | | | | | | |
Collapse
|
3
|
Zhang K, Li C, Hou K, Yu J. Role of the Cervical Anterior Spinal Artery in the Endovascular Treatment of Vascular Diseases: Bystander, Accomplice, Victim, or Friend? Front Neurol 2021; 12:761006. [PMID: 34764934 PMCID: PMC8576071 DOI: 10.3389/fneur.2021.761006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 09/22/2021] [Indexed: 11/13/2022] Open
Abstract
The cervical anterior spinal artery (ASA) is a very important artery arising from the intracranial vertebral artery (VA). It can play different roles in endovascular treatment (EVT) of spinal vascular diseases. The current understanding of these roles is incomplete; therefore, we performed this review. We found that cervical ASA can be involved in many spinal vascular diseases, such as arteriovenous fistula (AVF), arteriovenous malformation (AVM), and aneurysm, and can serve as a collateral channel in proximal VA occlusion. In AVF and AVM, when the cervical ASA is involved, it often plays the role of an accomplice or victim because it acts as the feeder or as a bystander that does not provide blood flow to the AVF and AVM. In cervical ASA aneurysm, the ASA is a victim. During EVT of VA aneurysms or stenoses, the cervical ASA ostia can be covered or occluded, resulting in ASA ischemia. In this situation, the ASA is a victim. In VA occlusion or the subclavian steal phenomenon, the cervical ASA can serve as a collateral channel to provide blood flow to the posterior circulation. In this case, the ASA plays the role of a friend. According to the role of the cervical ASA in spinal vascular diseases, EVT should be determined “case by case.” Most importantly, when EVT is performed to treat these diseases, the cervical ASA axis must be preserved. Therefore, understanding the role of the cervical ASA in spinal vascular diseases is crucial.
Collapse
Affiliation(s)
- Kun Zhang
- Department of Cerebrovascular Disease, Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, China
| | - Chao Li
- Department of Neurology, First Hospital of Jilin University, Changchun, China
| | - Kun Hou
- Department of Neurosurgery, First Hospital of Jilin University, Changchun, China
| | - Jinlu Yu
- Department of Neurosurgery, First Hospital of Jilin University, Changchun, China
| |
Collapse
|
4
|
Abstract
This article reviews the arterial and venous anatomy of the spine and spinal cord. Special emphasis is placed on vessels critical to the conduct and interpretation of spinal angiography, notably the intersegmental artery and its cranial and caudal derivatives: the vertebral, supreme intercostal, and sacral arteries.
Collapse
Affiliation(s)
- Philippe Gailloud
- Division of Interventional Neuroradiology, The Johns Hopkins Hospital, 1800 East Orleans Street, Baltimore, MD 21287, USA.
| |
Collapse
|
5
|
Uchino A, Saito N, Kurita H. Anastomosis of the external carotid artery and the V3 segment of the vertebral artery (presumed persistent second cervical intersegmental artery) diagnosed by CT angiography. Surg Radiol Anat 2017; 40:233-236. [PMID: 28765987 DOI: 10.1007/s00276-017-1906-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 07/27/2017] [Indexed: 11/24/2022]
Abstract
Congenital anastomosis of the external carotid (ECA) and vertebral (VA) arteries is extremely rare. We report a case of right ECA-VA anastomosis diagnosed by computed tomography (CT) angiography. The presumed dilated ascending pharyngeal artery coursed posteriorly and entered the C1 right transverse foramen. The proximal right VA was aplastic, and the C2 right transverse foramen was absent. Based on these findings, we diagnosed congenital anastomosis of the ECA and V3 segment of the VA, which we presumed to represent persistence of the second cervical intersegmental artery. Detection of rare variations of the vertebral arteries requires careful observation of CT angiography with bone images and source images, especially to identify the level of entry into the transverse foramen. Correct diagnosis of anastomosis is important when intravascular embolization or infusion chemotherapy or surgical ligation of the ECA is planned.
Collapse
Affiliation(s)
- Akira Uchino
- Departments of Diagnostic Radiology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan.
| | - Naoko Saito
- Departments of Diagnostic Radiology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan
| | - Hiroki Kurita
- Departments of Cerebrovascular Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| |
Collapse
|
6
|
Gailloud P. The Supreme Intercostal Artery in its Most Rudimentary Form Does Not Branch Off Any Intercostal Arteries. Anat Rec (Hoboken) 2015; 298:781-2. [DOI: 10.1002/ar.23092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 10/30/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Philippe Gailloud
- Division of Interventional Neuroradiology; The Johns Hopkins Hospital; 1800 E Orleans Street/Bloomberg 7218 Baltimore Maryland
| |
Collapse
|