Unknown internal carotid artery atherosclerotic stenoses detected with biphasic multidetector computed tomography for head and neck cancer

2005 ◽  
Vol 16 (4) ◽  
pp. 866-871 ◽  
Author(s):  
Nicola Flor ◽  
Francesco Sardanelli ◽  
Simone Soldi ◽  
Giuseppe Franceschelli ◽  
Caterina Missiroli ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Head And Neck Cancer ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Head And Neck ◽  
Multidetector Computed Tomography ◽  
Neck Cancer ◽  
Internal Carotid

Carotid Stenting and “Extarterectomy” in the Management of Head and Neck Cancer Involving the Internal Carotid Artery: Technical Case Report

Neurosurgery ◽  
2000 ◽  
Vol 47 (4) ◽  
pp. 981-984 ◽  
Author(s):  
Eric S. Nussbaum ◽  
Samuel C. Levine ◽  
David Hamlar ◽  
Michael T. Madison
Keyword(s):  
Head And Neck Cancer ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Head And Neck ◽  
Neck Cancer ◽  
Internal Carotid ◽  
Tumor Resection ◽  
Collateral Flow ◽  
Flow Through ◽  
Aggressive Tumor

Abstract OBJECTIVE AND IMPORTANCE Head and neck cancer that invades the internal carotid artery (ICA) represents a significant management challenge. We describe a novel technique that allows for aggressive tumor removal without disrupting blood flow through the affected ICA. CLINICAL PRESENTATION A 62-year-old man was referred to our institution for management of a neck malignancy involving the ICA. Cerebral angiography suggested that there was good collateral flow from the opposite hemisphere, but the patient reported visual loss in the ipsilateral eye during balloon test occlusion of the ICA. INTERVENTION A self-expanding stent was deployed in the ICA; it spanned the entire length of the artery involved by tumor. One month later, the patient underwent tumor resection. During surgery, a long ICA arteriotomy was performed directly down to the mesh of the stent. A neoendothelium had formed within the stent, which prevented arterial bleeding. The carotid wall was dissected from the stent without difficulty and removed en bloc with the surrounding tumor. The exposed stent was wrapped circumferentially with a synthetic patch material. The patient tolerated the procedure well, and postoperative angiography demonstrated normal filling of the ICA. CONCLUSION We describe a novel approach to a patient with head and neck cancer involving the cervical ICA. Preliminary stenting, which allows time for endothelialization before surgery, may permit aggressive tumor resection without interrupting flow through the ICA. This technique obviates the need for complicated carotid reconstruction procedures and avoids the risk of delayed ischemia from carotid sacrifice.

scholarly journals Transcarotid Mechanical Thrombectomy for Embolic Intracranial Large Vessel Occlusion after Endovascular Deconstructice Embolization for Carotid Blowout Syndrome

2020 ◽  
Vol 15 (1) ◽  
pp. 37-43 ◽  
Author(s):  
Chi-Ju Lu ◽  
Yen-Heng Lin ◽  
Chung-Wei Lee
Keyword(s):  
Head And Neck Cancer ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Head And Neck ◽  
Neck Cancer ◽  
Internal Carotid ◽  
Large Vessel ◽  
Large Vessel Occlusion ◽  
Vessel Occlusion ◽  
Carotid Blowout Syndrome

Carotid blowout syndrome (CBS) is a fatal complication of head and neck cancer. Endovascular treatment, particularly deconstructive embolization, is effective for CBS, but it might result in thromboembolic events. We report the case of a 57-year-old man with underlying recurrent head and neck cancer who had CBS. The patient received endovascular embolization of the right internal, external, and common carotid arteries. Right internal carotid artery to middle cerebral artery embolic occlusion was noted immediately after the procedure, and left-sided weakness and facial palsy were found. Ipsilateral suprabulbar cervical internal carotid artery puncture was performed under fluoroscopic guidance, and rescue suction thrombectomy was successful. The patient had no significant neurological sequela. Transcarotid intraarterial thrombectomy is a reasonable method for managing postembolization large vessel occlusion, even in the neck, after irradiation.

Extracranial-intracranial Bypass for Reconstruction of Internal Carotid Artery in the Management of Head and Neck Cancer

2003 ◽  
Vol 17 (3) ◽  
pp. 260-265 ◽  
Author(s):  
Hideaki Chazono ◽  
Yoshitaka Okamoto ◽  
Zensei Matsuzaki ◽  
Jun Ogino ◽  
Shuichiro Endo ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Head And Neck ◽  
Neck Cancer ◽  
Internal Carotid

Endovascular Management of Impending Carotid Rupture in a Patient with Advanced Head and Neck Cancer

2003 ◽  
Vol 10 (1) ◽  
pp. 54-57 ◽  
Author(s):  
Mark C. Bates ◽  
Fadi M. Shamsham
Keyword(s):  
Head And Neck Cancer ◽  
Carotid Artery ◽  
Head And Neck ◽  
Stent Graft ◽  
Neck Cancer ◽  
Coil Embolization ◽  
Internal Carotid ◽  
External Carotid ◽  
Recurrent Bleeding ◽  
The Common

Purpose: To describe an innovative endovascular technique combining a flexible self-expanding stent-graft to protect the common and internal carotid artery with selective coil embolization of the affected external carotid artery (ECA) branches. Case Report: A 42-year-old man presented with episodes of profuse but self-limited carotid hemorrhage from advanced squamous cell carcinoma of the neck. Despite invasion of the carotid sheath by the tumor, angiography confirmed the source of bleeding to be invasion of branches of the ECA. Successful coil embolization of the ECA and stent-graft isolation of the common/internal carotid arteries were performed. At 1-month follow-up, carotid angiography confirmed the complete occlusion of the ECA and patent stent-graft. There was no recurrent bleeding or neurological deficits at 6 months after the procedure. Conclusions: Stent-grafts in combination with coil embolization can be used to manage patients with impending carotid rupture secondary to head and neck cancer.

Developmental Anatomy of the Eustachian Tube: Implications for Balloon Dilation

2021 ◽  
pp. 019459982199481
Author(s):  
Isabelle Magro ◽  
David Pastel ◽  
Jace Hilton ◽  
Mia Miller ◽  
James Saunders ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Eustachian Tube ◽  
Internal Carotid ◽  
Tertiary Care ◽  
Balloon Dilation ◽  
Care Hospital ◽  
Developmental Anatomy ◽  
Nasal Floor

Objective To describe the developmental anatomy of the eustachian tube (ET) and its relationship to surrounding structures on computed tomography. Study Design Case series with chart review. Setting A tertiary care hospital. Methods ET anatomy was assessed with reformatted high-resolution computed tomography scans from 2010 to 2018. Scans (n = 78) were randomly selected from the following age groups: <4, 5 to 7, 8 to 18, and >18 years. The following were measured and compared between groups: ET length, angles, and relationship between its bony cartilaginous junction and the internal carotid artery and between its nasopharyngeal opening and the nasal floor. Results The distance between the bony cartilaginous junction and internal carotid artery decreased with age between the <4-year-olds (2.4 ± 0.6 mm) and the 5- to 7-year-olds (2.0 ± 0.3 mm, P = .001). The ET length increased among the <4-year-olds (32 mm), 5- to 7-year-olds (36 mm), and 8- to 18-year-olds (41 mm, P < .0001). The cartilaginous ET increased among the <4-year-olds (20 mm), 5- to 7-year-olds (25 mm), and 8- to 18-year-olds (28 mm, P < .0001). The ET horizontal angle increased among the <4-year-olds (17°), 5- to 7-year-olds (21°), and 8- to 18-year-olds (23°, P≤ .003), but the ET sagittal angle did not statistically change after 5 years of age. The height difference between the nasopharyngeal opening of the ET and the nasal floor increased among the <4-year-olds (4 mm), 5- to 7-year-olds (7 mm), and 8- to 18-year-olds (11 mm, P < .0001). Conclusion The ET elongates with age, and its angles and relationship to the nasal floor increase. Although some parameters mature faster, more than half of the ET growth occurs by 8 years of age, and adult morphology is achieved by early adolescence.

scholarly journals Long-Term Results of Carotid Artery Stenting in Veterans With Prior Head and Neck Cancer

2017 ◽  
Vol 66 (4) ◽  
pp. e91-e92
Author(s):  
Roy W. Jones ◽  
Adam Tanious ◽  
Paul Armstrong ◽  
Neil Moudgill ◽  
Karl A. Illig ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Carotid Artery ◽  
Head And Neck ◽  
Neck Cancer ◽  
Carotid Artery Stenting ◽  
Long Term Results

scholarly journals Elective reconstruction of thoracoabdominal aortic aneurysm type IV by transabdominal approach

2012 ◽  
Vol 69 (1) ◽  
pp. 90-93
Author(s):  
Ivan Marjanovic ◽  
Miodrag Jevtic ◽  
Sidor Misovic ◽  
Momir Sarac
Keyword(s):  
Computed Tomography ◽  
Aortic Aneurysm ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Thoracoabdominal Aortic Aneurysm ◽  
Aortic Dilatation ◽  
Aortic Reconstruction ◽  
Transabdominal Approach ◽  
Type Iv

Introduction. Thoracoabdominal aortic aneurysm (TAAA) type IV represents an aortic dilatation from the level of the diaphragmatic hiatus to the iliac arteries branches, including visceral branches of the aorta. In the traditional procedure of TAAA type IV repair, the body is opened using thoractomy and laparotomy in order to provide adequate exposure of the descending thoracic and abdominal aorta for safe aortic reconstruction. Case report. We reported a 71-yearold man with elective reconstruction of the TAAA type IV performed by transabdominal approach. Computed tomography scans angiography revealed a TAAA type IV with diameter of 62 mm in the region of celiac trunk and superior mesenteric artery branching, and the largest diameter of 75 mm in the infrarenal aortic level. The patient comorbidity included a chronic obstructive pulmonary disease and hypertension, therefore he was treated for a prolonged period. In preparation for the planned aortic reconstruction asymptomatic carotid disease (occlusion of the left internal carotid artery and subtotal stenosis of the right internal carotid artery) was diagnosed. Within the same intervention percutaneous transluminal angioplasty with stent placement in right internal carotid artery was made. In general, under endotracheal anesthesia and epidural analgesia, with transabdominal approach performed aortic reconstruction with tubular dakron graft 24 mm were, and reimplantation of visceral aortic branches into the graft performed. Postoperative course was uneventful, and the patient was discharged on the postoperative day 17. Control computed tomography scan angiography performed three months after the operation showed vascular state of the patient to be in order. Conclusion. Complete transabdominal approach to TAAA type IV represents an appropriate substitute for thoracoabdominal approach, without compromising safety of the patient. This approach is less traumatic, especially in patients with impaired pulmonary function, because there is no thoracotomy and any complications that could follow this approach.

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