Re: giant cavernous aneurysm associated with a persistent trigeminal artery and persistent otic artery.

Dear Editor,

We have an interesting article by Zhang et al. (1), named "Giant Cavernous Aneurysm Associated with a Persistent Trigeminal Artery and Persistent Otic Artery", which was published in the Sep/Oct 2009 issue of the journal. The patient in this report has an excellent outcome. However, we want to share more information about this case.

After the completion of the first endovascular procedure, the patient's right visual field defect improved without any evidence of clinically significant thromboembolic events during clinical follow-up. During the three-year follow up imaging study, the right cerebral blood supply collated well with the left internal carotid artery (ICA) from the anterior communicating artery. However, the aneurysm, albeit smaller in size, was still apparent, this time, originating from the right ICA, fed by the persistent trigeminal artery (PTA), not by the persistent otic artery (Fig. 1A).

Fig. 1

Left vertebral artery angiograms.

A. Left vertebral angiography revealed aneurysm fed by persistent trigeminal artery, which was smaller in size. B. Post embolization figure showing absence of the aneurysm.

In the second endovascular therapy, we had to embolize the aneurysm from the PTA (Fig. 1B). The patient underwent follow up twelve months after the procedure, and did not show any complicating ramifications of the procedure or any new thrombo-embolic events.