Fetal posterior communicating artery with aneurysm

Case contributed by Sovann Vathana Lay

Presentation

Diagnostic DSA for aneurysm seen in MRI

Patient Data

Age: 65 years
Gender: Female

Left frontal ICA run demonstrates a large posterior communicating artery in a fetal position with a large saccular aneurysm arising from it.

Lateral view of left ICA run

dsa

This lateral view clearly demonstrated a prominent posterior communicating artery with the aforementioned aneurysm.

Left vertebral artery run in frontal view

dsa

Frontal view of left vertebral artery run demonstrated an absence of left posterior cerebral artery (P1).

Injection of left vertebral artery shows no P1 segment and its supplying territories.

Axial MR angiography in time-of-fly sequences done prior to DSA showed the fetal posterior communicating artery with its aneurysm.

Case Discussion

Fetal posterior communicating artery is a common anatomical variant to be observed in routine DSA run.

Knowledge of this variation will serve in multiple scenarios such as uncommon ischemic stroke territory or a decision to occlude intra-cranial arteries etc.

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