{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T05:32:33Z","timestamp":1775539953090,"version":"3.50.1"},"reference-count":11,"publisher":"FapUNIFESP (SciELO)","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. vasc. bras."],"abstract":"<jats:p>Abstract We report an exceptional case of a large right persistent proatlantal artery (PPPA), defined as a \u201cmixed\u201d type, because it originated as in Type 2 from the external carotid artery and courses as in Type1, i.e. over the vertebral artery groove of the posterior arch of C1, entering the skull via the foramen magnum, without passing through the transverse foramen of any of the cervical vertebra. This \u201cmixed\u201d PPPA was associated first with an azygos anterior cerebral artery and second with a left common carotid artery arising from the brachiocephalic trunk. The right occipital artery arose from the PPPA. In addition, an aneurysm arose from the kinked right cervical internal carotid artery. This case illustrated an association not reported previously, making treatment of the concomitant aneurysm challenging. Moreover, understanding of persistent carotid-vertebral anastomosis is essential to enable evaluation and management before performing endovascular treatment, especially in cases of basilar thrombectomy and for posterior circulation strokes.<\/jats:p>","DOI":"10.1590\/1677-5449.202400482","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T11:12:29Z","timestamp":1748603549000},"source":"Crossref","is-referenced-by-count":1,"title":["Unusual anatomical variations of cervical and cranial arteries with surgical interest: case report"],"prefix":"10.1590","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8691-9004","authenticated-orcid":false,"given":"Monique","family":"Boukobza","sequence":"first","affiliation":[{"name":"Paris University,  France; Bichat-Claude Bernard Hospital,  France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Pierre","family":"Laissy","sequence":"additional","affiliation":[{"name":"Paris University,  France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","published-online":{"date-parts":[[2025]]},"reference":[{"issue":"4","key":"ref1","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.3171\/2010.11.JNS101527","article-title":"Persistent fetal intracranial arteries: a comprehensive review of anatomical and clinical significance","volume":"114","author":"Tubbs RS","year":"2011","journal-title":"J Neurosurg"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1016\/j.jocn.2018.11.028","article-title":"A rare case report of a mixed persistent proatlantal intersegmental artery","volume":"61","author":"Ma GT","year":"2019","journal-title":"J Clin Neurosci"},{"issue":"3","key":"ref3","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/j.bj.2020.02.004","article-title":"Management of intracranial vertebral artery stenosis with ipsilateral vertebral artery hypoplasia and contralateral vertebral artery occlusion via type 2 proatlantal intersegmental artery","volume":"44","author":"Lin CM","year":"2021","journal-title":"Biomed J"},{"issue":"7","key":"ref4","doi-asserted-by":"crossref","first-page":"139","DOI":"10.5797\/jnet.cr.2023-0007","article-title":"Mechanical thrombectomy for basilar artery occlusion with a type 1 persistent proatlantal artery: a case report and literature review","volume":"17","author":"Ito S","year":"2023","journal-title":"J Neuroendovasc Ther."},{"issue":"10","key":"ref5","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1212\/WNL.13.10.825","article-title":"Studies on the arteries of the brain. II. The anterior cerebral artery: some anatomic features and their clinical implications","volume":"13","author":"Baptista AG","year":"1963","journal-title":"Neurology"},{"issue":"5","key":"ref6","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1007\/s00276-022-02928-5","article-title":"Embryology of the anterior communicating artery complex: implications on possible adult variants","volume":"44","author":"Bonasia S","year":"2022","journal-title":"Surg Radiol Anat"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.wneu.2022.05.127","article-title":"Intracranial Aneurysms in the Context of Variant Cerebrovascular Anatomy: A Review of the Literature","volume":"165","author":"Scullen T","year":"2022","journal-title":"World Neurosurg"},{"issue":"3","key":"ref8","doi-asserted-by":"crossref","first-page":"191","DOI":"10.2176\/nmc.30.191","article-title":"Type 2 proatlantal artery associated with a ruptured aneurysm--case report","volume":"30","author":"Kurose K","year":"1990","journal-title":"Neurol Med Chir (Tokyo)"},{"issue":"11","key":"ref9","doi-asserted-by":"crossref","first-page":"5018","DOI":"10.21037\/qims-22-89","article-title":"Carotid tortuosity is associated with extracranial carotid artery aneurysms","volume":"12","author":"van Laarhoven CJHCM","year":"2022","journal-title":"Quant Imaging Med Surg"},{"issue":"10","key":"ref10","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1111\/ene.13720","article-title":"Experience of a single center in the conservative approach of 20 consecutive cases of asymptomatic extracranial carotid artery aneurysms","volume":"25","author":"Pourier VEC","year":"2018","journal-title":"Eur J Neurol"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.ejvssr.2017.11.002","article-title":"Treatment of extracranial carotid artery aneurysms: what is known and what is unknown?","volume":"38","author":"de Borst GJ","year":"2017","journal-title":"EJVES Short Rep"}],"container-title":["Jornal Vascular Brasileiro"],"original-title":["Varia\u00e7\u00f5es anat\u00f4micas invulgares das art\u00e9rias cervicais e cranianas com interesse cir\u00fargico: relato de caso"],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S1677-54492025000100606&tlng=en","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T11:12:31Z","timestamp":1748603551000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S1677-54492025000100606&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":11,"alternative-id":["S1677-54492025000100606"],"URL":"https:\/\/doi.org\/10.1590\/1677-5449.202400482","relation":{},"ISSN":["1677-7301","1677-5449"],"issn-type":[{"value":"1677-7301","type":"electronic"},{"value":"1677-5449","type":"print"}],"subject":[],"published":{"date-parts":[[2025]]},"article-number":"e20240048"}}