scholarly journals Carotid Artery Stenting to Prevent Stroke in a Patient with Bilateral Extracranial Internal Carotid Dissection and Vasospasm following Rupture of an Intracranial Aneurysm

2003 ◽  
Vol 9 (3) ◽  
pp. 305-310 ◽  
Author(s):  
J. Sedat ◽  
M. Dib ◽  
J. Szapiro ◽  
P. Paquis
Keyword(s):  
Cerebral Ischemia ◽  
Carotid Artery ◽  
Intracranial Aneurysm ◽  
Carotid Artery Stenting ◽  
Internal Carotid ◽  
Anticoagulation Therapy ◽  
Clinical Grade ◽  
Carotid Dissection ◽  
Aneurysmal Rupture ◽  
Therapeutic Anticoagulation

The stenting of carotid dissection has been described for the prevention of cerebral ischemia in patients who remain symptomatic despite therapeutic anticoagulation, in those who present contraindications for anticoagulation therapy, or who present a local or extensive stenosis, with an associated pseudoaneurysm. We here report a case associating a high clinical grade aneurysmal rupture with a bilateral extracranial carotid dissection. Because of the haemodynamic risk due to the acute bilateral stenosis-induced dissection and the occurrence of a vasospasm, the carotid dissections were treated with self-expendable stents.

scholarly journals Carotid artery stenting for patients with occipital–vertebral anastomosis

2018 ◽  
Vol 25 (2) ◽  
pp. 212-218
Author(s):  
Ryuichiro Kajikawa ◽  
Toshiyuki Fujinaka ◽  
Hajime Nakamura ◽  
Manabu Kinoshita ◽  
Takeo Nishida ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Vertebral Artery ◽  
High Intensity ◽  
Carotid Artery Stenting ◽  
Internal Carotid ◽  
External Carotid ◽  
Occipital Artery ◽  
Protection Method ◽  
Distal Internal Carotid Artery

Background and purpose We report the outcomes of carotid artery stenting for patients with angiographically visible occipital artery–vertebral artery anastomosis. Methods Among 47 consecutive patients who underwent carotid artery stenting from January 2007 to December 2010, seven patients for whom cerebral angiograms clearly showed occipital artery–vertebral artery anastomosis were selected. Four different protection methods were used: distal internal carotid artery protection; carotid flow reversal; seatbelt and airbag technique; and double protection method of protecting both the external and internal carotid artery. Results One patient with distal internal carotid artery protection showed a high-intensity lesion at the border of the upper thalamus, internal capsule and lateral ventricle wall after carotid artery stenting. The other patient with the double protection method did not show any high-intensity lesions on postoperative diffusion-weighted imaging in the vertebrobasilar territory. All seven patients with visible occipital artery–vertebral artery anastomosis showed ipsilateral vertebral artery severe stenosis or occlusion. Conclusion Large occipital artery–vertebral artery anastomosis may be a pathway for embolic materials during carotid artery stenting. External carotid artery protection is recommended for carotid artery stenting in such patients.

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