Pipeline embolization device-assisted angioplasty for type II proatlantal intersegmental artery dissection inducing an embolic shower

The proatlantal intersegmental artery (PIA) plays a crucial role in blood supply during embryonic development, and failure of its closure can lead to the persistent proatlantal intersegmental artery (PPIA), which may result in pathological changes such as dissection and aneurysms. We present a case...

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Main Authors: Li Bao, Zhenguo Pan, Haifeng Ji, Shuang He
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-02-01
Series:Frontiers in Neurology
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Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1490799/full
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author Li Bao
Li Bao
Zhenguo Pan
Haifeng Ji
Shuang He
author_facet Li Bao
Li Bao
Zhenguo Pan
Haifeng Ji
Shuang He
author_sort Li Bao
collection DOAJ
description The proatlantal intersegmental artery (PIA) plays a crucial role in blood supply during embryonic development, and failure of its closure can lead to the persistent proatlantal intersegmental artery (PPIA), which may result in pathological changes such as dissection and aneurysms. We present a case of a patient with right type II PPIA dissection inducing an embolic shower, accompanied by left vertebral artery hypoplasia (VAH). Digital subtraction angiography (DSA) and high-resolution magnetic resonance vascular wall imaging (HRMR-VWI) showed the aneurysmal dilation of the false lumen in the right PPIA dissection and indicated the high risk of mural thrombosis and dislodgement. Following a comprehensive evaluation of the patient’s condition, we conducted pipeline embolization device (PED)-assisted angioplasty to treat the PPIA dissection and mitigate the risk of recurrent strokes. Postoperative follow-up indicated that the patient recovered smoothly, with no signs of recurrent stroke. This case highlights the critical need for prompt recognition and intervention in cases of rare vascular variants. The flow diverter implantation can greatly enhance patient outcomes and lower the risk of recurrent strokes, offering important insights for the clinical management of similar cases. Additional research is necessary to investigate the underlying pathological mechanisms of PPIA and its connection to stroke occurrence, which will help refine treatment strategies in the future.
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spelling doaj-art-d11eb221efb145aca2555b7dc3ca6da32025-02-04T05:28:12ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-02-011610.3389/fneur.2025.14907991490799Pipeline embolization device-assisted angioplasty for type II proatlantal intersegmental artery dissection inducing an embolic showerLi Bao0Li Bao1Zhenguo Pan2Haifeng Ji3Shuang He4Department of Stroke Center, Affiliated Hospital of Nantong University, Nantong, ChinaMedical College of Nantong University, Nantong, ChinaDepartment of Neurology, Xiangshui People’s Hospital, Yancheng, ChinaDepartment of Neurology, Xiangshui People’s Hospital, Yancheng, ChinaDepartment of Stroke Center, Affiliated Hospital of Nantong University, Nantong, ChinaThe proatlantal intersegmental artery (PIA) plays a crucial role in blood supply during embryonic development, and failure of its closure can lead to the persistent proatlantal intersegmental artery (PPIA), which may result in pathological changes such as dissection and aneurysms. We present a case of a patient with right type II PPIA dissection inducing an embolic shower, accompanied by left vertebral artery hypoplasia (VAH). Digital subtraction angiography (DSA) and high-resolution magnetic resonance vascular wall imaging (HRMR-VWI) showed the aneurysmal dilation of the false lumen in the right PPIA dissection and indicated the high risk of mural thrombosis and dislodgement. Following a comprehensive evaluation of the patient’s condition, we conducted pipeline embolization device (PED)-assisted angioplasty to treat the PPIA dissection and mitigate the risk of recurrent strokes. Postoperative follow-up indicated that the patient recovered smoothly, with no signs of recurrent stroke. This case highlights the critical need for prompt recognition and intervention in cases of rare vascular variants. The flow diverter implantation can greatly enhance patient outcomes and lower the risk of recurrent strokes, offering important insights for the clinical management of similar cases. Additional research is necessary to investigate the underlying pathological mechanisms of PPIA and its connection to stroke occurrence, which will help refine treatment strategies in the future.https://www.frontiersin.org/articles/10.3389/fneur.2025.1490799/fullproatlantal intersegmental arterypipeline embolization devicedissectionstrokeangioplastyHR-VWI
spellingShingle Li Bao
Li Bao
Zhenguo Pan
Haifeng Ji
Shuang He
Pipeline embolization device-assisted angioplasty for type II proatlantal intersegmental artery dissection inducing an embolic shower
Frontiers in Neurology
proatlantal intersegmental artery
pipeline embolization device
dissection
stroke
angioplasty
HR-VWI
title Pipeline embolization device-assisted angioplasty for type II proatlantal intersegmental artery dissection inducing an embolic shower
title_full Pipeline embolization device-assisted angioplasty for type II proatlantal intersegmental artery dissection inducing an embolic shower
title_fullStr Pipeline embolization device-assisted angioplasty for type II proatlantal intersegmental artery dissection inducing an embolic shower
title_full_unstemmed Pipeline embolization device-assisted angioplasty for type II proatlantal intersegmental artery dissection inducing an embolic shower
title_short Pipeline embolization device-assisted angioplasty for type II proatlantal intersegmental artery dissection inducing an embolic shower
title_sort pipeline embolization device assisted angioplasty for type ii proatlantal intersegmental artery dissection inducing an embolic shower
topic proatlantal intersegmental artery
pipeline embolization device
dissection
stroke
angioplasty
HR-VWI
url https://www.frontiersin.org/articles/10.3389/fneur.2025.1490799/full
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AT zhenguopan pipelineembolizationdeviceassistedangioplastyfortypeiiproatlantalintersegmentalarterydissectioninducinganembolicshower
AT haifengji pipelineembolizationdeviceassistedangioplastyfortypeiiproatlantalintersegmentalarterydissectioninducinganembolicshower
AT shuanghe pipelineembolizationdeviceassistedangioplastyfortypeiiproatlantalintersegmentalarterydissectioninducinganembolicshower