Supplementary Material for: Posterior circulation mechanical thrombectomy through primitive trigeminal artery: A case report

Introduction: Primitive trigeminal artery (PTA) is a rare intracranial vascular malformation, and mechanical thrombectomy and revascularization via PTA are rarely reported.
Case presentation: We reported a case of mechanical thrombectomy through PTA in a patient who presented with sudden slurred speech and had a National Institutes of Health Stroke Scale score of 12. Digital subtraction angiography of the cerebral vasculature showed PTA formation in the right internal carotid artery cavernous segment, with acute occlusion of the distal basilar artery at the PTA junction, and bilateral vertebral arteries and proximal basilar artery were underdeveloped. Therefore, we chose mechanical thrombectomy via PTA; but unfortunately, the vessel failed to recanalize. Follow-up at 1 month post-procedure indicated that the patient had passed away. We present the endovascular process and analyze and summarize the reasons for the failure to provide a reference for subsequent mechanical thrombectomy via PTA.
Conclusions: PTA increases the risk of ischemic stroke and adds to the complexity of mechanical thrombectomy post-stroke. However, in certain situations, PTA can be used as a thrombectomy channel to increase the first-line possibility of timely endovascular treatment to save ischemic brain tissue.

引言：原始三叉动脉（Primitive trigeminal artery, PTA）是一种罕见的颅内血管畸形，经PTA实施机械取栓及血管重建术的病例报道极为少见。
病例报告：本研究报道1例经PTA行机械取栓术的病例：患者以突发言语含糊为首发症状，美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale, NIHSS）评分为12分。数字减影脑血管造影（Digital subtraction angiography, DSA）显示，患者右侧颈内动脉海绵窦段可见PTA形成，基底动脉远端于PTA汇合处发生急性闭塞，双侧椎动脉及基底动脉近端发育不良。遂为患者实施经PTA机械取栓术，但遗憾的是血管未能实现再通。术后1个月随访显示患者已死亡。本研究详细阐述该手术的血管内操作过程，分析并总结手术失败的原因，以期为后续经PTA机械取栓术的临床实践提供参考依据。
结论：PTA会增加缺血性脑卒中的发病风险，同时提升卒中后机械取栓术的操作复杂度。但在特定临床情境下，PTA可作为取栓通路，提高及时血管内治疗的一线可行性，从而挽救缺血脑组织。