ReviewSurgical and radiologic anatomy : SRA2026
The persistent proatlantal artery: types and subtypes.
Review in Surgical and radiologic anatomy : SRA, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Double vertebral artery-connected persisting proatlantal artery coexisting with a persisting carotid duct in an adult case: first evidence.Surgical and radiologic anatomy : SRA · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe persistent proatlantal artery (PPA) is the most caudal of the four persistent carotid–vertebrobasilar anastomoses and is frequently misclassified because “Type I/Type II” terminology variably reflects arterial origin and/or cervical course.
objectiveTo synthesise embryology, imaging criteria, and clinically relevant PPA variants, and to harmonise nomenclature including Cohen’s Type II “spinal” and “occipital” subtypes.
methodsA Scale for the Assessment of Narrative Review Articles (SANRA)-guided narrative review of PubMed/MEDLINE and Google Scholar (inception to February 2025) was performed. Data extracted included origin (internal carotid artery, external carotid artery [ECA], or common carotid artery), relationship to the C1 transverse foramen, vertebral artery (VA) status, occipital artery (OA) incorporation, and procedural relevance. An illustrative computed tomography angiography (CTA) index case was included.
resultsEvidence is dominated by case reports and small series. PPA is very uncommon (reported incidence ~ 0.01% in multi-slice CTA cohorts) and often accompanies ipsilateral VA hypoplasia/aplasia, sometimes providing the dominant posterior fossa supply. Course-forward interpretation distinguishes canonical Type I suboccipital pathways from Type II ECA/occipital-system pathways, including “occipital” Type II channels that bypass transverse foramina and can mimic Type I. In the index case, a 73-year-old woman had an ECA-origin Type II (occipital subtype) PPA that gave rise to the OA and continued as the extracranial VA before entering the skull via the foramen magnum.
conclusionStandardised, course-based reporting, explicitly documenting origin, transverse foramen traversal, and posterior circulation dependence, reduces diagnostic ambiguity and supports safer planning for ECA interventions, carotid endarterectomy, and craniovertebral junction/skull-base surgery.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.