Ventral Clival Branch of the Ascending Pharyngeal Artery as a Transosseous Feeder of an Arteriovenous Fistula Surrounding the Clival Lesions,Clinical Neuroradiology

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Ventral Clival Branch of the Ascending Pharyngeal Artery as a Transosseous Feeder of an Arteriovenous Fistula Surrounding the Clival Lesions
Clinical Neuroradiology ( IF 2.4 ) Pub Date : 2022-12-07 , DOI: 10.1007/s00062-022-01232-4
Wataro Tsuruta ₁ , Tomokazu Sekine ₁ , Daiichiro Ishigami ₁ , Shigeta Fujitani ₁ , Arisa Tomioka ₁ , Yuki Kamiya ₁ , Hisayuki Hosoo ₂ , Yoshiro Ito ₃ , Aiki Marushima ₃ , Mikito Hayakawa ₂ , Yuji Matsumaru ₂

Affiliation

Purpose

Arteriovenous fistulas (AVFs) adjacent to the clivus, such as cavernous sinus dural AVFs (CSDAVFs) and condylar AVFs, sometimes have an intraosseous shunted pouch and recruit blood supply from transosseous feeders. Precise analysis of transosseous feeders regarding the clival lesion has not yet been performed. Therefore, this study aimed to clarify the characteristics and identity of transosseous feeders in clival lesions.

Methods

Patients with CSDAVFs and condylar AVFs, who underwent high-resolution cone-beam computed tomography or three-dimensional rotational angiography in our institute, were included. The frequency, type of branch, penetrating point, and termination of intraosseous feeders were retrospectively evaluated.

Results

A total of 31 patients with 36 lesions in CSDAVFs and 8 patients with 8 lesions in condylar AVFs underwent angiography. For CSDAVFs, 38 transosseous feeders were detected in 23 out of 31 patients, including 22 in the pharyngeal branch of the ascending pharyngeal artery (APhA), 6 in the hypoglossal branch of the APhA, 6 in the accessory meningeal artery, 3 in the meningohypophyseal trunk (MHT), and 1 in the anterior branch of the middle meningeal artery. For condylar AVFs, 24 transosseous feeders were detected in all 8 patients, including 11 in the pharyngeal branches of the APhA, 7 in the hypoglossal branch of the APhA, 6 in the segmental artery from the vertebral artery, and 2 in the MHT.

Conclusion

Transosseous feeders of AVFs around the clivus, which are frequently seen in AVFs of this area, mainly arise from ventral clival branches and from pharyngeal branches of the APhA.

中文翻译：

咽升动脉的腹侧斜坡分支作为围绕斜坡病变的动静脉瘘的经骨支

目的

与斜坡相邻的动静脉瘘 (AVF)，例如海绵窦硬脑膜 AVF (CSDAVF) 和髁突 AVF，有时具有骨内分流袋并从经骨供血器募集血液供应。尚未对有关斜坡病变的经骨供料器进行精确分析。因此，本研究旨在阐明斜坡病变中经骨供食器的特征和特性。

方法

包括在我们研究所接受高分辨率锥形束计算机断层扫描或三维旋转血管造影术的 CSDAVF 和髁突 AVF 患者。回顾性评估骨内供料器的频率、分支类型、穿透点和终止。

结果

共31例CSDAVFs 36处病变和8例髁突AVFs 8处病变行血管造影。CSDAVFs，31例患者中23例检出38条经骨供血管，其中咽升动脉（APhA）咽支22例，APhA舌下支6例，副脑膜动脉6例，脑膜垂体3例主干 (MHT)，1 支位于脑膜中动脉前支。对于髁突 AVF，在所有 8 名患者中检测到 24 个经骨供血器，其中 11 个位于 APhA 的咽支，7 个位于 APhA 的舌下支，6 个位于椎动脉的节段动脉，2 个位于 MHT。