Carotid-Carotid Bypass Graft for Internal Carotid Artery Kinking Causing Dysphagia

2017 ◽  
Vol 43 ◽  
pp. 310.e5-310.e7 ◽  
Author(s):  
Francesco Stilo ◽  
Vincenzo Catanese ◽  
Manuele Casale ◽  
Silvia Bernardini ◽  
Nunzio Montelione ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Bypass Graft

Treatment of Acute Traumatic Internal Carotid Artery Occlusion with Extracranial-to-Intracranial Arterial Bypass: Case Report

Neurosurgery ◽  
1989 ◽  
Vol 25 (1) ◽  
pp. 90-92 ◽  
Author(s):  
Brian T. Andrews
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Bypass Graft ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
High Flow ◽  
Cerebral Hypoperfusion ◽  
Barbiturate Coma ◽  
Arterial Bypass

Abstract Ligation of the cervical internal carotid artery resulted in an acute neurological deficit in the dominant hemisphere of a 35-year-old man who suffered a penetrating injury to the neck. Regional cerebral hypoperfusion was suspected because the ischemic symptoms occurred while the patient was fully heparinized. Immediate institution of a barbiturate coma, volume expansion, and placement of a high-flow extracranial-intracranial arterial bypass graft led to rapid recovery of hemispheric function. High-flow extracranial-intracranial bypass grafts appear to be indicated for the treatment of symptomatic cerebral ischemia in selected cases of acute ligation or occlusion of the extracranial carotid artery.

Common carotid to intracranial internal carotid bypass venous graft

1971 ◽  
Vol 34 (1) ◽  
pp. 114-118 ◽  
Author(s):  
William M. Lougheed ◽  
Brian M. Marshall ◽  
Michael Hunter ◽  
Ernest R. Michel ◽  
Harley Sandwith-Smyth
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Bypass Graft ◽  
Left Internal Carotid Artery ◽  
Anterior Clinoid Process ◽  
Content Type ◽  
The Common ◽  
The Right ◽  
Inside Out

✓ A 54-year-old woman was admitted with a complete occlusion of the right internal carotid artery and a 25% stenosis of the left internal carotid artery. Intracranial circulation on the right side was restored by taking a vein from the leg and anastomosing the vein of the intracranial carotid artery just distal to the anterior clinoid process. Prior to insertion the vein was turned inside out, the valves removed and then reinverted allowing the distal end of the vein to be anastomosed to the intracranial internal carotid artery. The blood flow was therefore reversed in the vein. The proximal end of the vein was anastomosed to the common carotid artery. Upon completion there was excellent circulation in the bypass graft and internal carotid artery.

Transaxillary Carotid Stenting: Technical Case Report

2005 ◽  
Vol 56 (suppl_4) ◽  
pp. ONS-E441-ONS-E441 ◽  
Author(s):  
Huan Wang ◽  
James L. Swischuk ◽  
Kenneth Fraser ◽  
Jorge Alvernia ◽  
Giuseppe Lanzino
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Ultrasound Guidance ◽  
Internal Carotid ◽  
Bypass Graft ◽  
Carotid Stenting ◽  
Left Internal Carotid Artery ◽  
Transfemoral Approach ◽  
Transaxillary Approach ◽  
Increased Risk

Abstract OBJECTIVE AND IMPORTANCE: As endovascular neurointerventions continue to evolve rapidly, angioplasty and stenting of both the extracranial and intracranial vessels have become more routine procedures. When the transfemoral approach is contraindicated or technically difficult, familiarity with alternative access techniques becomes essential. We report a successful transaxillary carotid stenting in a patient with an axillary bifemoral bypass graft. CLINICAL PRESENTATION: A 77-year-old man presented with a symptomatic high-grade stenosis (80%) of the left internal carotid artery. Because of the increased risk of general anesthesia related to his advanced age and severe comorbidities, stenting of the left internal carotid artery was considered. A left transaxillary approach was chosen because of the presence of an axillary bifemoral bypass graft. TECHNIQUE: Under ultrasound guidance, the left axillary artery was successfully punctured and cannulated. After a 0.038 Magic Torque wire (Boston Scientific/Medi-Tech, Watertown, MA) was anchored with the tip of the wire in the distal left occipital artery, a 7-French (outer diameter) Vista Bright guiding sheath (Cordis, Miami, FL) was successfully positioned in the mid left common carotid artery, with an MPA catheter (Cordis) used as guiding support. Subsequently, two Precise stents (Cordis) were successfully deployed across the stenosis, yielding a satisfactory angiographic result. CONCLUSION: With proper patient selection and the use of ultrasound guidance during the initial puncture, the transaxillary approach is a safe and technically feasible alternative to the transfemoral approach when performing carotid stenting.

scholarly journals Surgical Trapping With Revascularization of Concomitant Cervical and Petrous Internal Carotid Artery Aneurysms: 2-Dimensional Operative Video

2019 ◽  
Vol 17 (6) ◽  
pp. E242-E243 ◽  
Author(s):  
Hussam Abou-Al-Shaar ◽  
Yair M Gozal ◽  
Philipp Taussky ◽  
William T Couldwell
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Nasal Bone ◽  
Ground Level ◽  
Lymphocytic Leukemia ◽  
Facial Trauma ◽  
External Carotid

Abstract Petrous internal carotid artery (ICA) aneurysms are rare, complicated lesions to treat. The management paradigms include observation, endovascular exclusion, or surgical trapping with or without revascularization. The case described in this video involved a 67-yr-old woman with a known history of chronic lymphocytic leukemia, who presented after a mechanical ground-level fall. Clinically, she had a nasal deformity and resolving epistaxis consistent with mild facial trauma. Computed tomography (CT) revealed a comminuted nasal bone fracture and an incidental 3-cm right petrous ICA aneurysm. Subsequent vascular imaging demonstrated a concurrent 1.5-cm right cervical ICA dissecting pseudoaneurysm. Flow diversion with a Pipeline stent (Medtronic, Dublin, Ireland) was unsuccessful because the aneurysm's size precluded microcatheter selection of the ICA distal to the lesion. When the patient did not tolerate balloon test occlusion of the ICA, we proceeded with surgical trapping of both aneurysms and high-flow extracranial-to-intracranial bypass. The patient underwent a right frontotemporal craniotomy and an external carotid artery–to–frontal M2 middle cerebral artery bypass with a radial artery graft. Following a clinoidectomy, an aneurysm clip was applied to the paraclinoid ICA, and the cervical ICA was ligated just distal to the bifurcation, effectively trapping both aneurysms. The patient tolerated the procedure well. Postoperatively, she experienced symptomatic hypotension requiring vasopressor therapy and a transient partial oculomotor palsy that resolved during her hospital course. She was discharged home without neurological sequelae. Postoperative CT angiography demonstrated complete exclusion of the ICA aneurysms and a patent radial bypass graft after surgery and at 6-month follow-up. The patient provided consent for publication.

Large and Giant Paraclinoid Aneurysms: Surgical Techniques, Complications, and Results

Neurosurgery ◽  
1983 ◽  
Vol 12 (2) ◽  
pp. 153-163 ◽  
Author(s):  
Roberto C. Heros ◽  
Paul B. Nelson ◽  
Robert G. Ojemann ◽  
Robert M. Crowell ◽  
Gerard DeBrun
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Bypass Graft ◽  
Surgical Techniques ◽  
The Other ◽  
Carotid Occlusion ◽  
Anterior Clinoid Process ◽  
Carotid Ligation ◽  
Paraclinoid Aneurysms

Abstract Twenty-five patients with giant (>25 mm in diameter) and 9 patients with large (15 to 25 mm in diameter) aneurysms of the internal carotid artery in the ophthalmic or paraophthalmic region are reviewed. In 23 of these patients the aneurysm was clipped directly. There was 1 death in this group, and none of the survivors had disabling neurological complications outside the visual system. The other 11 patients were treated by a trapping procedure or by either common carotid ligation or internal carotid ligation in the neck. Of the 5 patients treated by internal carotid ligation preceded by an extracranial to intracranial bypass graft, 3 developed embolic complications, which in 1 patient resulted in death. One of the 4 patients treated by ligation of the common carotid artery died 1 year later from a recurrent subarachnoid hemorrhage. Of the total group, 18 patients had visual loss preoperatively as a result of aneurysmal compression; in 10 the vision was improved by operation, in 3 it was made worse, and in 2 it was unchanged. In another patient the vision continued to deteriorate slowly after common carotid occlusion, and the other 2 patients died postoperatively before vision could be assessed. The complications in the patients are described and analyzed in detail. Maneuvers found to be of value in the direct approach to these lesions are described. Of these, exposure of the internal carotid artery in the neck for temporary occlusion during clipping and thorough drilling of the anterior clinoid process and unroofing of the optic canal were particularly helpful. The literature on indirect methods of treatment by carotid occlusion with and without bypass graft is reviewed with special reference to the complications and effectiveness of each alternative. Based on this review of the literature and our experience, a treatment scheme is suggested for these aneurysms depending on their mode of presentation.

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