Concomitant Surgical Treatment of Symptomatic Carotid Artery Disease With a Coexisting Shamblin I Carotid Body Tumor

Symptomatic carotid artery atherosclerotic disease is an indication for carotid artery endarterectomy. The coexistence of carotid body tumors (CBTs) with symptomatic carotid disease is rarely encountered and adds significant challenges to vascular surgeons, with a reported overall mortality for patients who undergo endarterectomy and tumor excision of 8.8%, as opposed to the 2% for those who had CBT excision only. We describe the case of a 79-year-old female who experienced an acute cerebrovascular accident in the left hemisphere; duplex ultrasound revealed high-grade carotid stenosis in the left side and the presence of a Shamblin I CBT. The risks and benefits of the planned operation were reviewed, and the decision was made to proceed with early carotid endarterectomy and concomitant surgical resection of the tumor using the retrocarotid dissection technique. The patient recovered well, and at 11 months from the combined procedure, her neurological deficits improved significantly.

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Carotid Endarterectomy for Symptomatic Carotid Artery Disease Demonstrated by Duplex Ultrasound With Minimal Arteriographic Findings

Annals of Vascular Surgery ◽

10.1007/bf02286785 ◽

1996 ◽

Vol 10 (4) ◽

pp. 385-389 ◽

Cited By ~ 6

Author(s):

Ali F. AbuRahma ◽

John F. White ◽

James P. Boland

Keyword(s):

Carotid Artery ◽

Carotid Endarterectomy ◽

Carotid Artery Disease ◽

Duplex Ultrasound ◽

Symptomatic Carotid ◽

Artery Disease

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Evaluation of haemodynamic impairment and collateral flow in symptomatic carotid artery disease using arterial spin labelling MRI

Aktuelle Neurologie ◽

10.1055/s-2005-919686 ◽

2005 ◽

Vol 32 (S 4) ◽

Author(s):

R Kern ◽

M Günther ◽

F Sallustio ◽

K Szabo ◽

M Griebe ◽

...

Keyword(s):

Carotid Artery ◽

Carotid Artery Disease ◽

Arterial Spin Labelling ◽

Collateral Flow ◽

Symptomatic Carotid ◽

Artery Disease ◽

Spin Labelling

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Preventing stroke in symptomatic carotid artery disease during the COVID-19 pandemic

Journal of Vascular Surgery ◽

10.1016/j.jvs.2020.04.476 ◽

2020 ◽

Vol 72 (2) ◽

pp. 755-756

Author(s):

Joyce Hellegering ◽

Maarten J. van der Laan ◽

Erik-Jan de Heide ◽

Maarten Uyttenboogaart ◽

Clark J. Zeebregts ◽

...

Keyword(s):

Carotid Artery ◽

Carotid Artery Disease ◽

Symptomatic Carotid ◽

Artery Disease

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Exploration of a zero-tolerance regime on cerebral embolism in symptomatic carotid artery disease

Perspectives in Medicine ◽

10.1016/j.permed.2012.02.064 ◽

2012 ◽

Vol 1 (1-12) ◽

pp. 218-223 ◽

Cited By ~ 1

Author(s):

Ruud W.M. Keunen ◽

Agnes van Sonderen ◽

Maayke Hunfeld ◽

Michael Remmers ◽

D.L. Tavy ◽

...

Keyword(s):

Carotid Artery ◽

Carotid Artery Disease ◽

Zero Tolerance ◽

Cerebral Embolism ◽

Symptomatic Carotid ◽

Artery Disease

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Circulating Microparticles in Patients with Symptomatic Carotid Disease Are Related to Embolic Plaque Activity and Recent Cerebral Ischaemia

Cerebrovascular Diseases Extra ◽

10.1159/000495942 ◽

2019 ◽

Vol 9 (1) ◽

pp. 9-18 ◽

Cited By ~ 2

Author(s):

Neghal Kandiyil ◽

Shane T. MacSweeney ◽

Stan Heptinstall ◽

Jane May ◽

Susan C. Fox ◽

...

Keyword(s):

Carotid Artery ◽

Cerebral Ischaemia ◽

Carotid Artery Disease ◽

Transcranial Doppler Ultrasound ◽

Risk Markers ◽

Stroke Patients ◽

Symptomatic Carotid ◽

Circulating Microparticles ◽

Artery Disease ◽

Embolic Signals

Background and Purpose: In order to assess the association of microparticles derived from activated platelets (PMP) or endothelial cells (EMP) with risk markers for recurrent embolic events in patients with symptomatic carotid artery disease, we studied the associations between PMP/EMP and three risk markers: plaque haemorrhage (PH), micro-embolic signals and cerebral diffusion abnormalities. Methods: Patients with recently symptomatic high-grade carotid artery stenosis (60–99%, 42 patients, 31 men; mean age 75 ± 8 years) and 30 healthy volunteers (HV, 11 men; mean age 56 ± 12 years) were prospectively recruited. Patients were characterised by carotid magnetic resonance imaging (presence of PH [MRI PH]), brain diffusion MRI (cerebral ischaemia [DWI+]) and transcranial Doppler ultrasound (micro-embolic signals [MES+]). PMP and EMP were classified by flow cytometry and expressed as log-transformed counts per microlitre. Results: MES+ patients (n = 18) had elevated PMP (MES+ 9.61 ± 0.57) compared to HV (8.80 ± 0.73; p < 0.0001) and to MES– patients (8.55 ± 0.85; p < 0.0001). Stroke patients had elevated PMP (9.49 ± 0.64) and EMP (6.13 ± 1.0) compared to non-stroke patients (PMP 8.81 ± 0.73, p = 0.026, EMP 5.52 ± 0.65, p = 0.011) and HV (PMP 8.80 ± 0.73, p = 0.007, and EMP 5.44 ± 0.47, p = 0.006). DWI+ patients (n = 16) showed elevated PMP (DWI+ 9.53 ± 0.64; vs. HV, p = 0.002) and EMP (DWI+ 5.91 ± 0.99 vs. HV 5.44 ± 0.47; p = 0.037). Only PMP but not EMP were higher in DWI+ versus DWI– patients (8.67 ± 0.90; p = 0.002). No association was found between PMP and EMP with MRI PH. Conclusions: PMP and EMP were associated with stroke and recent cerebrovascular events (DWI+) but only PMP were also associated with ongoing (MES+) thrombo-embolic activity suggesting a differential biomarker potential for EMP to index cerebral ischaemia while PMP may predict on-going thrombo-embolic activity.

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