{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T12:47:20Z","timestamp":1772110040629,"version":"3.50.1"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,12,16]],"date-time":"2021-12-16T00:00:00Z","timestamp":1639612800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Pure arterial malformations (PAMs) are extremely rare abnormalities defined as dilated, overlapping, and tortuous arteries with a coil-like appearance in the absence of venous components. Over the last half century, only seven published reports have described cases of patients with PAMs who received treatment.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Here, we report two cases of women with PAMs who received surgical treatment, and we present a systematic review of the literature. We searched the PubMed, Embase, Web of Science, and Medline databases (up until October 1, 2021) for relevant publications. We performed independent-sample <jats:italic>t<\/jats:italic>-tests and Fisher's exact tests to compare continuous and categorical characteristics among the available cases.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Our first patient was a 43-year-old woman with PAM of the left internal carotid artery (ICA), who received an ICA-radial artery (RA)-M2 bypass. Post-operative digital subtraction angiography (DSA) revealed the disappearance of the left ICA PAM without ischemic events during follow-up. The second patient was a 53-year-old woman with PAMs of the right ICA and posterior cerebral artery. The P1 lesion was treated by proximal occlusion combined with a superficial temporal artery-P2 bypass. During the 12-month follow-up period, the size of the PAMs decreased significantly as indicated by the post-operative DSA showing the absence of hemorrhages. Our systematic review, which includes 56 PAMs, shows that the reported PAMs were more common in the anterior circulation (33\/56, 58.9%) than in the posterior circulation (11\/56, 19.7%). Bilateral PAMs were more likely to affect bilateral anterior cerebral arteries (ACA) (ACA<jats:sub>bilateral<\/jats:sub> vs. ACA<jats:sub>unilateral<\/jats:sub>: 63.6 vs. 26.2%, <jats:italic>p<\/jats:italic> = 0.02). In addition, PAMs involving the anterior circulation were likely to affect multiple arteries (anterior<jats:sub>multi<\/jats:sub> vs. posterior<jats:sub>multi<\/jats:sub>: 30.3 vs. 0%, <jats:italic>p<\/jats:italic> = 0.038).<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> We found very few reports on treated PAMs; further studies with large sample sizes and long follow-up periods are required to explore the appropriate treatment strategy for PAMs.<\/jats:p>","DOI":"10.3389\/fneur.2021.755312","type":"journal-article","created":{"date-parts":[[2021,12,16]],"date-time":"2021-12-16T06:58:14Z","timestamp":1639637894000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Cerebral Revascularization for the Management of Symptomatic Pure Arterial Malformations"],"prefix":"10.3389","volume":"12","author":[{"given":"Xiaocheng","family":"Lu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinggen","family":"Fang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yabo","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Waleed","family":"Brinjikji","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,12,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"655","DOI":"10.3171\/2013.4.JNS121374","article-title":"Pure arterial malformation of the posterior cerebral artery: importance of its recognition","volume":"119","author":"McLaughlin","year":"2013","journal-title":"J Neurosurg."},{"key":"B2","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1227\/00006123-198608000-00017","article-title":"Surgically treated cerebral arterial ectasia with so-called moyamoya vessels","volume":"19","author":"Hanakita","year":"1986","journal-title":"Neurosurgery."},{"key":"B3","doi-asserted-by":"publisher","first-page":"575","DOI":"10.3171\/2013.7.JNS131478","article-title":"Pure arterial malformations of the posterior cerebral artery","volume":"120","author":"Lanzino","year":"2014","journal-title":"J Neurosurg."},{"key":"B4","doi-asserted-by":"publisher","first-page":"E67","DOI":"10.1093\/ons\/opy382","article-title":"Clipping of basilar perforator pure arterial malformation aneurysm: 2-dimensional operative video","volume":"17","author":"Munich","year":"2019","journal-title":"Oper Neurosurg."},{"key":"B5","doi-asserted-by":"publisher","first-page":"e52","DOI":"10.1016\/j.wneu.2019.07.020","article-title":"Progressive pure arterial malformations of the anterior cerebral artery","volume":"131","author":"Yue","year":"2019","journal-title":"World Neurosurg."},{"key":"B6","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1016\/j.wneu.2019.12.093","article-title":"Spontaneous subarachnoid hemorrhage from a pure pial arterial malformation in the lateral cerebellomedullary junction: clinical images with a surgical video","volume":"135","author":"Li","year":"2019","journal-title":"World Neurosurg."},{"key":"B7","doi-asserted-by":"publisher","first-page":"200","DOI":"10.11817\/j.issn.1672-7347.2021.190673","article-title":"Pure arterial malformation with associated aneurysmal subarachnoid hemorrhage: two case reports and literature review","volume":"46","author":"Yao","year":"2021","journal-title":"Zhong Nan Da Xue Xue Bao Yi Xue Ban."},{"key":"B8","doi-asserted-by":"publisher","first-page":"e1000097","DOI":"10.1371\/journal.pmed.1000097","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"6","author":"Moher","year":"2009","journal-title":"PLoS Med."},{"key":"B9","first-page":"95","article-title":"Dolicho-ectatic intracranial arteries: symptomatology and pathogenesis of arterial elongation and distention","volume":"125","author":"Sacks","year":"1969","journal-title":"Johns Hopkins Med J."},{"key":"B10","doi-asserted-by":"publisher","first-page":"92","DOI":"10.2214\/ajr.115.1.92","article-title":"Lipomas of the corpus callosum. 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