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Neuroradiology

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01-08-2021 | Computed Tomography | Interventional Neuroradiology

Angio-anatomical study of the pterygovaginal artery based on cone-beam computed tomography

Authors: Keisuke Yoshida, Takenori Akiyama, Eytan Raz, Dai Kamamoto, Hiroyuki Ozawa, Masahiro Toda

Published in: Neuroradiology | Issue 8/2021

Abstract

Purpose

To investigate the anatomical characteristics and clinical implications of the pterygovaginal artery (PtVA), a recurrent branch from the distal internal maxillary artery (IMA), which courses through the pterygovaginal canal that connects the pterygopalatine fossa and nasopharynx.

Methods

Eighty-two patients with 90 sides of cone-beam computed tomography (CBCT) reconstructed from rotational angiography of the external or common carotid artery with a field of view covering the pterygopalatine fossa were retrospectively reviewed. The origin from the IMA, branching type, distribution, and anastomoses was evaluated. The underlying lesions were 36 hypervascular lesions with possible supply from PtVA (17 cavernous sinus arteriovenous fistulas (AVFs), 6 anterior condylar AVFs, and 13 nasopharyngeal, parasellar, or paraclival tumors) and 46 other diseases.

Results

PtVA was identified in 75 sides (83%). It originated from the pterygopalatine segment of the IMA in 45 sides (60%) and from the pterygoid segment in 30 sides (40%). It arose independently (77%), sharing the common trunk with the Vidian artery (15%) or with other branches. It ran posteromedially through the pterygovaginal canal to supply the mucosa over the nasopharyngeal roof, the choanae, and the pharyngeal ostium of the eustachian tube. It anastomosed with the ascending pharyngeal artery (n=37), the accessory meningeal artery (n=7), and the mandibular artery from the petrous internal carotid artery (n=2). It served as a feeder of osseous AVFs and skull base tumors.

Conclusion

PtVA was often identified by CBCT even in normal anatomy. Its detailed angio-anatomy could be evaluated in the presence of parasellar or paraclival hypervascular lesions.

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Title: Angio-anatomical study of the pterygovaginal artery based on cone-beam computed tomography
Authors: Keisuke Yoshida
Takenori Akiyama
Eytan Raz
Dai Kamamoto
Hiroyuki Ozawa
Masahiro Toda
Publication date: 01-08-2021
Publisher: Springer Berlin Heidelberg
Keywords: Computed Tomography
Angiography
Computed Tomography
Arteriovenous Fistula
Arteriovenous Fistula
Published in: Neuroradiology / Issue 8/2021
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-021-02657-3

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Springer Medicine

Angio-anatomical study of the pterygovaginal artery based on cone-beam computed tomography

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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