A very small vessel, seen more often when specifically looked for, and pretty much always in setting of pathology — either steno-occlusive ICA disease with ECA reconstitution, or arteriovenous shunts such as cavernous sinus dural fistula. Another treacherous connection between the IMAX and the ophthalmic/ ICA, if there weren’t enough already. The point is to look for it, and especially with Cone Beam CT — patient-specific evaluation.
ICA Reconstitution, including SOF Artery participation
Case of Drs. Raz and Sharashidze
Circles and arrows point to it. Connects the artery of foramen rotundum to the ophthalmic. Bottom left view is sagittal oblique, bottom right coronal oblique
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The same case, full picture below — multiple other ICA reconstitution routes
Dashed black arrow — ophthalmic; ball arrow — ILT; arrow — sphenoid branch MMA; dashed arrow — artery of foramen rotundum; open arrow — accessory meningeal; arrowhead — infraorbital/ophthalmic branch; black arrow — superior orbital fissure branch
Another example, in a patient with a very strange petrosal MMA fistula — not shown for privacy reasons. I don’t think the SOF Artery participates in the fistula, and seems to be “normal” here
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Multiple SOF Arteries in a cavernous fistula
As far as arteries go, where there is one, there is infinity…
Guess what…there are many more arteries out there than we can see. Just give them a chance to grow, and dural fistula is one way to do it. Call it “angiogenesis” or whatever — when there is flow demand, the vessels answer. Arteries enlarge to supply shunts — by whatever genetic or molecular mechanisms it takes. Here are a myriad of SOF and zillions other unnamed arteries all coming into one spot in the cavernous sinus — which is why fistulas die when venous pouches are closed
Here is a taste of the millions of others. The 6D fusion, with injection from the right especially, showing confluence of arteries upon the fistula
We have many more examples of the SOF Artery in case you still think its that rare, and will fill them here as time allows to dig them out
Literature
