Congenital absence of the internal carotid artery and the basilar artery with persistent trigeminal artery associated with coarctation of the aorta

We report a case of congenital absence of the cervical and petrous part of the left internal carotid artery, the middle and proximal part of the basil ar artery, and the V4 segment of the left vertebral artery associated with a left persistent trigeminal artery and a coarctation of the aorta. The lef t cerebral vessels are supplied via the anterior communicating artery and t he left persistent trigeminal artery. The coexisting coarctation of the aor ta led to a subclavian steal phenomenon. The alteration of the cerebral hem odynamics has to be taken in consideration when performing cerebral angiogr aphy and surgical correction in such a case.