scholarly journals Carotid Blowout Treated by Direct Percutaneous Puncture of Internal Carotid Artery with Temporary Balloon Occlusion

2005 ◽  
Vol 11 (4) ◽  
pp. 349-354 ◽  
Author(s):  
F.-C. Chang ◽  
J.-F. Lirng ◽  
C.-B. Luo ◽  
M.M.H. Teng ◽  
W.-Y. Guo ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Common Carotid Artery ◽  
Internal Carotid ◽  
External Carotid ◽  
Difficult Case ◽  
Endovascular Management ◽  
Percutaneous Puncture ◽  
Antegrade Flow ◽  
The Right

Direct percutaneous puncture of a cervical carotid pseudoaneurysm for coil placement or acrylic embolization is described for the endovascular management of acute carotid blowout. However, direct puncture of the internal carotid artery (ICA) for the endovascular management of carotid blowout has not been described. We report a difficult case of acute carotid blowout syndrome in a patient who had radiation-induced occlusion of the right common carotid artery with vasculopathy and pseudoaneurysm in the right cervical ICA. Collaterals from the branches of the controlateral external carotid artery (ECA) anastomosed with branches of right ECA supplied the vasculopathy. We performed direct percutaneous puncture of the bulb of the right ICA using a spinal needle and placed fiber coils to occlude antegrade flow of the artery. During the injection of a mixture of N-butyl cyanoacrylate and lipiodol oil for embolization of the remaining carotid bulb, we transiently inflated an occlusion balloon in the controlateral common carotid artery to further arrest antegrade flow in the ICA. The vasculopathy and pseudoaneurysm of the right cervical ICA were successfully embolized, with preservation of the distal branches of the right ICA.

scholarly journals The use of high-resolution MRI to detect thrombosis and lipid-rich carotid artery plaques in a patient with homozygous familial hypercholesterolemia

2020 ◽  
Vol 66 (1) ◽  
pp. 31-35 ◽  
Author(s):  
Zhenjia Wang ◽  
Wen Liu ◽  
Long Jiang ◽  
Luya Wang ◽  
Wei Yu
Keyword(s):  
High Resolution ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Familial Hypercholesterolemia ◽  
Common Carotid Artery ◽  
Internal Carotid ◽  
External Carotid ◽  
Homozygous Familial Hypercholesterolemia ◽  
High Resolution Mri ◽  
The Right

SUMMARY Homozygous familial hypercholesterolemia is a rarely agentic disorder of the lipoprotein metabolism intimately related to premature atherosclerotic cardiovascular disease that can lead to high disability and mortality. Homozygous familial hypercholesterolemia typically affects not only the aortic root, compromising the coronary ostia, but also affects other territories such as the carotid, descending aorta, and renal arteries. Multi-contrast high-resolution magnetic resonance imaging (MRI) provides a validated and useful method to characterize carotid artery atherosclerotic plaques quantitatively. However, very few studies have been done on assessing plaque composition in patients with Homozygous familial hypercholesterolemia using high-resolution MRI. This report is to evaluate the value of MRI in accessing carotid artery disease in patients with Homozygous familial hypercholesterolemia. We describe a 28-year-old patient from Beijing, China, who presented to the Neurology Clinic with intermittent blurred vision of the right eye, headache, nausea, and vomiting for eight years without obvious causes. Familial hypercholesterolemia was suspected based on medical history and laboratory examination. Carotid Doppler ultrasound showed bilateral common carotid artery, internal carotid artery, and external carotid artery wall thickening with hyperechoic signals. Subsequently, high-resolution multi-contrast MRI of the carotid showed calcification with hypo-intense areas located at the middle layer of the plaque, with moderate stenosis. The plaque located at the right bifurcation of the common carotid artery extended to the internal carotid artery, causing lumen stenosis close to occlusion. The patient was treated with right carotid artery endarterectomy. At a 6-month follow-up, there had been no recurrence of the patient’s symptoms.

Carotid Artery Stenting under Flow Arrest for the Management of Intraluminal Thrombus: Technical Case Report

2008 ◽  
Vol 63 (suppl_1) ◽  
pp. ONSE87-ONSE88 ◽  
Author(s):  
Ramachandra P. Tummala ◽  
Babak S. Jahromi ◽  
Junichi Yamamoto ◽  
Elad I. Levy ◽  
Adnan H. Siddiqui ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Stent Placement ◽  
Internal Carotid ◽  
External Carotid ◽  
Left Internal Carotid Artery ◽  
Carotid Stent ◽  
Intraluminal Thrombus ◽  
Antegrade Flow

Abstract Objective The management of intraluminal carotid thrombus is not well defined. Medical and surgical management carry a relatively high risk of thromboembolism. Although endovascular options also carry the risk of thromboembolism from manipulation of the lesion, successful carotid stent placement using various methods of flow restriction has been reported anecdotally. We describe a technique to arrest antegrade flow before placement of carotid stents in the setting of symptomatic intraluminal thrombus. Clinical Presentation A 49-year-old woman presented with expressive dysphasia, right-upper extremity weakness, and an episode of left monocular blindness. Angiography confirmed the presence of a large intraluminal thrombus in a chronic dissection of the left internal carotid artery. Results We devised a configuration to arrest antegrade flow in the internal carotid artery before crossing the thrombus with a distal embolic protection device by inflating balloons in the common carotid artery and external carotid artery before crossing the lesion. After inflation of a balloon in the internal carotid artery, we completed overlapping stent placement to completely exclude the thrombus from the lumen. Conclusion The patient remained neurologically unchanged during and immediately after the procedure. She had mild neurological deficits at the 1 month follow-up evaluation. Follow-up ultrasonography at 1 and 3 months and computed tomographic angiography at 3 months after the procedure showed patency of the stented carotid artery, with no evidence of restenosis or thrombus. Although the risks of carotid stent placement for intraluminal thrombus remain unclear, the technique of flow arrest seems to provide a safe endovascular treatment option.

scholarly journals An Important Clue in the Sonographic Diagnosis of Internal Carotid Artery Agenesis: Ipsilateral Common Carotid Artery Hypoplasia

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Omer Kaya ◽  
Cengiz Yilmaz ◽  
Bozkurt Gulek ◽  
Gokhan Soker ◽  
Gokalp Cikman ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Common Carotid Artery ◽  
Internal Carotid ◽  
Radiology Department ◽  
Left Internal Carotid Artery ◽  
Doppler Us ◽  
Healthcare Center ◽  
Important Clue ◽  
The Right

A 42-year-old female patient, who had been diagnosed with an occlusion of her left internal carotid artery (ICA) following Doppler ultrasonographic (US) and digitally-subtracted angiographic (DSA) examinations performed in an outer healthcare center in order to eliminate the underlying cause of her complaint of amorosis fugax, later applied to our hospital with the same complaint. At Doppler US performed in our hospital’s radiology department, her right common carotid artery (CCA) was normal, but her left CCA was hypoplastic. The right internal artery (ICA) was validated as normal. At the left side, however, the ICA was apparent only as a stump and it did not demonstrate a continuity. The diagnosis of ICA agenesis was confirmed by the utilization of Doppler US, CT, and DSA imaging, and it was concluded also that ipsilateral CCA hypoplasia could be evaluated as an important clue to the diagnosis of ICA agenesis.

scholarly journals Left Common Carotid Artery Agenesis with Hypoplastic Left Internal Carotid Artery Originating from the Aortic Arch: A Rare Anomaly Presenting with Internal Carotid Artery Aneurysm and Subarachnoid Hemorrhage

2017 ◽  
Vol 01 (01) ◽  
pp. 049-052 ◽  
Author(s):  
Mandeep Ghuman ◽  
Vivek Gupta ◽  
Shankhneel Singh ◽  
S. Dhandapani ◽  
N. Khandelwal
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Common Carotid Artery ◽  
Internal Carotid ◽  
Left Common Carotid Artery ◽  
Vascular Pathology ◽  
External Carotid ◽  
Left Internal Carotid Artery ◽  
Radiographic Appearance

AbstractMost arch anomalies are asymptomatic and detected incidentally on imaging or on autopsy. Occasionally, such anomalies can manifest clinically when associated with another vascular pathology such as an intracranial aneurysm. In this report, we describe a rare case of agenesis of the left common carotid artery with separate origin of the left internal carotid artery and the external carotid artery from the arch discovered on digital subtraction angiography performed during the evaluation of subarachnoid hemorrhage. Knowledge of such anomalies and radiographic appearance is essential for interventional neuroradiologist in planning treatment of such cases.

Agenesis of the cervical internal carotid artery

1989 ◽  
Vol 103 (7) ◽  
pp. 707-709 ◽  
Author(s):  
T. Nishimura ◽  
T. Takimoto ◽  
M. Kamide ◽  
S. Ishikawa ◽  
R. Umeda
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Radical Surgery ◽  
Vascular Anomaly ◽  
External Carotid Artery ◽  
External Carotid ◽  
Digital Subtraction ◽  
Cervical Portion ◽  
The Right

AbstractTotal or segmental agenesis of the internal carotid artery is a rare anomaly. The cervical portion of the internal carotid artery was absent in the right side of the patient who was carried out radical surgery due to recurrent oropharyngeal cancer. Post-operative venous digital subtraction angiography revealed that the remaining intracranial portion of the internal carotid artery was normally patent and supplied blood flow via ipsilateral external carotid artery. Otolaryngologist-Head and Neck surgeon should know such a vascular anomaly and avoid a disastrous result on dividing external carotid artery.

Absence of the right common carotid artery: Doppler ultrasonographic and MR angiographic findings

Vascular ◽  
2014 ◽  
Vol 22 (5) ◽  
pp. 364-367 ◽  
Author(s):  
Fatma Esra Bahadır Ulger ◽  
Aykut Ulger ◽  
Mustafa Colak
Keyword(s):  
Carotid Artery ◽  
Common Carotid Artery ◽  
Doppler Ultrasonography ◽  
Internal Carotid ◽  
Incidental Finding ◽  
Color Doppler ◽  
External Carotid Artery ◽  
External Carotid ◽  
The Right ◽  
Angiographic Findings

We present a case of common carotid artery agenesis which is an extremely rare congenital anomaly. Less than 35 cases have been reported. These anomalies are typically asymptomatic and usually discovered as an incidental finding. Color Doppler ultrasonography is an effective and sensitive method for detecting absence of common carotid artery. But it is insufficient to identify the anomaly as a whole. Magnetic resonance angiography is a complementary technique to describe the origin of the external carotid artery and internal carotid artery.

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