scholarly journals Carotid Endarterectomy for Internal Carotid Artery Stenosis Associated with Persistent Primitive Hypoglossal Artery: Efficacy of Intraoperative Multi-modality Monitoring

2009 ◽  
Vol 52 (05/06) ◽  
pp. 263-266 ◽  
Author(s):  
M. Kawabori ◽  
S. Kuroda ◽  
H. Yasuda ◽  
M. Hokari ◽  
N. Nakayama ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Carotid Endarterectomy ◽  
Carotid Artery Stenosis ◽  
Internal Carotid ◽  
Internal Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Hypoglossal Artery ◽  
Persistent Primitive Hypoglossal Artery

Symptomatic internal carotid artery stenosis in the presence of a persistent primary hypoglossal artery

Vascular ◽  
2020 ◽  
pp. 170853812096651
Author(s):  
Marie Burgard ◽  
Emmanouil Psathas ◽  
Pasquale Mordasini ◽  
Friedrich Medlin ◽  
Markus Menth ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Internal Carotid ◽  
Internal Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Protection Device ◽  
Transient Ischemic Attacks ◽  
Hypoglossal Artery ◽  
Persistent Primitive Hypoglossal Artery

Objectives Anatomic variations of the extracranial carotid artery are rare. Persistent primitive hypoglossal artery appears with a reported incidence between 0.03% and 0.2%. We report a case of recurrent transient ischemic attacks originating from proximal internal carotid artery stenosis associated with ipsilateral persistent primitive hypoglossal artery and give a review of the existing literature. Methods A 78-year-old patient with a medical history of two previous transient ischemic attacks consulted our emergency department with an acute left hemispheric stroke. Intravenous thrombolysis permitted complete resolution of symptoms. Concurrent Computed Tomography (CT) and Magnetic Resonance (MR) angiography revealed an unstable plaque causing 50% stenosis of the left internal carotid artery with a persistent primitive hypoglossal artery dominantly perfusing the posterior circulation, and bilateral hypoplastic vertebral arteries. Results Uneventful carotid artery stenting using a proximal protection device was performed, and the patient was discharged after 12 days. Six months follow-up was uneventful with a patent stent in the internal carotid artery. Conclusions Treatment of symptomatic carotid artery stenosis in the presence of persistent primitive hypoglossal artery is challenging. Management should be driven by patients’ co-morbidities, the anatomical localization of the lesions and local expertise. In the case of a high origin of the persistent primary hypoglossal artery, carotid artery stenting with the use of a proximal cerebral protection device is probably the preferred and simplest approach.

scholarly journals Staged Carotid Stenting and Carotid Endarterectomy for Bilateral Internal Carotid Artery Stenosis

2003 ◽  
Vol 9 (1_suppl) ◽  
pp. 143-148 ◽  
Author(s):  
H. Fukuda ◽  
K. Iihara ◽  
N. Sakai ◽  
K. Murao ◽  
H. Sakai ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Carotid Endarterectomy ◽  
Complication Rate ◽  
Carotid Artery Stenosis ◽  
Internal Carotid ◽  
Carotid Stenting ◽  
Internal Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Minor Stroke

The purpose of this study was to evaluate the efficacy and safety of staged carotid stenting (CS) and carotid endarterectomy (CEA) for bilateral internal carotid artery stenosis. With this strategy, initial carotid stenting was performed for the high grade carotid stenosis to reduce the risk of subsequent CEA. Eight patients were treated with staged CS and CEA; CS for asymptomatic side followed by CEA for symptomatic side. Sufficient revascularization was obtained in all procedures but one CS procedure. Two minor stroke caused by distal embolism occurred during the perioperative period of CS. Postprocedural persistent hypotension was observed in one CS procedure. The mean interval between CS and CEA was 19.8 days. In conclusion, although our strategy has some advantages such as avoidance of bilateral cranial nerve palsy and shorter admission period over staged CEA, relatively high complication rate was noted at the first CS without any stroke morbidity post CEA. Our preliminary result showed that further reduction of periprocedural complication rate at the initial stenting is mandatory for this approach justified.

Effect of Carotid Endarterectomy on Chronic Ocular Ischemic Syndrome Due to Internal Carotid Artery Stenosis

Neurosurgery ◽  
2001 ◽  
Vol 48 (2) ◽  
pp. 328-333 ◽  
Author(s):  
Shoichiro Kawaguchi ◽  
Shuzo Okuno ◽  
Toshisuke Sakaki ◽  
Norikiyo Nishikawa
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Carotid Endarterectomy ◽  
Carotid Artery Stenosis ◽  
Ophthalmic Artery ◽  
Internal Carotid ◽  
Color Doppler ◽  
Internal Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Artery Flow

Abstract OBJECTIVE We evaluated the effect of carotid endarterectomy on chronic ocular ischemic syndrome due to internal carotid artery stenosis by use of data obtained from ophthalmic artery color Doppler flow imaging. METHODS We examined 11 patients with ocular ischemic syndrome due to internal carotid artery stenosis (>70% stenosis) who were being treated by carotid endarterectomy. Ophthalmic artery color Doppler flow imaging indicated ophthalmic artery flow direction and peak systolic flow velocity and was performed before and at 1 week, 1 month, and 3 months after surgery. RESULTS We assessed the ophthalmic arteries of 11 patients via color Doppler flow imaging. Before undergoing carotid endarterectomy, five patients showed reversed ophthalmic artery flow. In the other six patients who experienced antegrade ophthalmic artery flow, the average peak systolic flow velocity was 0.09 ± 0.05 m/s (mean ± standard deviation). Preoperative reversed flow resolved in each patient 1 week after undergoing surgery. All patients showed antegrade ophthalmic artery flow. The average peak systolic flow velocity in the patients who had preoperative antegrade flow rose significantly, to 0.21 ± 0.14 m/s (P < 0.05). There was no significant change as compared with findings at 1 week after surgery. During the follow-up period (mean, 32.4 mo), no patients complained of recurrent visual symptoms. At the end of the study period, visual acuity had improved in five patients and had not worsened in the other six patients. CONCLUSION Carotid endarterectomy was effective for improving or preventing the progress of chronic ocular ischemia caused by internal carotid artery stenosis.

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