scholarly journals Preoperative Embolization of Brain Tumor with Pial Artery or Dural Branch of Internal Carotid Artery as Feeding Artery

2006 ◽  
Vol 12 (1_suppl) ◽  
pp. 246-251 ◽  
Author(s):  
M Hirohata ◽  
T Abe ◽  
N Fujimura ◽  
Y Takeuchi ◽  
M Shigemori
Keyword(s):  
Brain Tumor ◽  
Carotid Artery ◽  
Blood Loss ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Tumor Resection ◽  
Preoperative Embolization ◽  
Digital Subtraction ◽  
Feeding Artery ◽  
Pial Artery

This study evaluated the clinical usefulness of preoperative embolization of the pial artery or dural branch of the internal carotid artery (ICA) for brain tumor. Subjects comprised 17 patients with large hypervascular brain tumors who underwent preoperative selective embolization. Micro-catheters (2- or 1.7-F) and shapeable hydrophilic micro-guide wires were used for pial artery (branching from the posterior or anterior cerebral artery) or ICA dural branch embolization. Embolization was performed under digital subtraction fluoroscopy with Polyvinyl alcohol (PVA) particles (150–250 mm) and/or liquid coil. Tumor resection was performed immediately or the day after embolization. Digital subtraction angiography (DSA) before and after endovascular devascularization, blood loss during tumor resection, and clinical outcome were evaluated. All endovascular procedures were technically successful. Post-embolization DSA revealed either a disappearance or a marked decrease of the tumor stain in all cases. Control of intraoperative bleeding was easily accomplished, and intraoperative blood loss was low. Preoperative particle embolization of the feeding artery from the cortical artery or ICA dural branch is safe and effective as adjuvant therapy before tumor resection.

Preoperative Embolization of Brain Tumor with Pial Artery or Dural Branch of Internal Carotid Artery as Feeding Artery

1995 ◽  
Vol 8 (6) ◽  
pp. 246-251
Author(s):  
M Hirohata ◽  
T Abe ◽  
N Fujimura ◽  
Y Takeuchi ◽  
M Shigemori
Keyword(s):  
Brain Tumor ◽  
Carotid Artery ◽  
Blood Loss ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Tumor Resection ◽  
Preoperative Embolization ◽  
Digital Subtraction ◽  
Feeding Artery ◽  
Pial Artery

This study evaluated the clinical usefulness of preoperative embolization of the pial artery or dural branch of the internal carotid artery (ICA) for brain tumor. Subjects comprised 17 patients with large hypervascular brain tumors who underwent preoperative selective embolization. Micro-catheters (2- or 1.7-F) and shapeable hydrophilic micro-guide wires were used for pial artery (branching from the posterior or anterior cerebral artery) or ICA dural branch embolization. Embolization was performed under digital subtraction fluoroscopy with Polyvinyl alcohol (PVA) particles (150–250 mm) and/or liquid coil. Tumor resection was performed immediately or the day after embolization. Digital subtraction angiography (DSA) before and after endovascular devascularization, blood loss during tumor resection, and clinical outcome were evaluated. All endovascular procedures were technically successful. Post-embolization DSA revealed either a disappearance or a marked decrease of the tumor stain in all cases. Control of intraoperative bleeding was easily accomplished, and intraoperative blood loss was low. Preoperative particle embolization of the feeding artery from the cortical artery or ICA dural branch is safe and effective as adjuvant therapy before tumor resection.

scholarly journals Pipeline embolization device retraction and foreshortening after internal carotid artery blister aneurysm treatment

2017 ◽  
Vol 23 (6) ◽  
pp. 614-619 ◽  
Author(s):  
Jeremy J Heit ◽  
Nicholas A Telischak ◽  
Huy M Do ◽  
Robert L Dodd ◽  
Gary K Steinberg ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
High Morbidity ◽  
Case Description ◽  
Digital Subtraction ◽  
Pipeline Embolization Device ◽  
Aneurysm Occlusion ◽  
New Treatment

Background Subarachnoid hemorrhage (SAH) secondary to rupture of a blister aneurysm (BA) results in high morbidity and mortality. Endovascular treatment with the pipeline embolization device (PED) has been described as a new treatment strategy for these lesions. We present the first reported case of PED retraction and foreshortening after treatment of a ruptured internal carotid artery (ICA) BA. Case description A middle-aged patient presented with SAH secondary to ICA BA rupture. The patient was treated with telescoping PED placement across the BA. After 5 days from treatment, the patient developed a new SAH due to re-rupture of the BA. Digital subtraction angiography revealed an increase in caliber of the supraclinoid ICA with associated retraction and foreshortening of the PED that resulted in aneurysm uncovering and growth. Conclusions PED should be oversized during ruptured BA treatment to prevent device retraction and aneurysm regrowth. Frequent imaging follow up after BA treatment with PED is warranted to ensure aneurysm occlusion.

Embolic stroke after carotid artery ligation during carotid body tumor resection

Vascular ◽  
2011 ◽  
Vol 21 (1) ◽  
pp. 23-26
Author(s):  
Hyangkyoung Kim ◽  
Yong-Pil Cho ◽  
Ki-Myung Moon ◽  
Tae-Won Kwon
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Carotid Body ◽  
Internal Carotid ◽  
Tumor Resection ◽  
Antiplatelet Agents ◽  
Carotid Body Tumor ◽  
Tumor Surgery ◽  
Artery Ligation ◽  
Carotid Artery Ligation

This report describes a case of a delayed cerebral embolic infarction, after internal carotid artery (ICA) ligation secondary to carotid body tumor resection. We describe a 34-year-old woman who underwent left ICA ligation during a large carotid body tumor surgery. Immediately after surgery, the patient was neurologically asymptomatic; however, she subsequently developed a cerebral embolic infarction nine hours postoperatively. After beginning antiplatelet therapy, all symptoms ultimately resolved, although over a gradual course. Since the ligation of the ICA can cause thromboembolic infarctions of the cerebrum, we contend that antiplatelet agents be administered to prevent and/or treat embolic strokes.

Evaluation of Recombinant Tissue Plasminogen Activator in Embolic Stroke

Neurosurgery ◽  
1989 ◽  
Vol 24 (3) ◽  
pp. 355-360 ◽  
Author(s):  
B. Barry Chehrazi ◽  
J. Anthony Seibert ◽  
Phillip Kissel ◽  
Larry Hein ◽  
John M. Brock
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cerebral Infarction ◽  
Plasminogen Activator ◽  
Internal Carotid ◽  
Embolic Stroke ◽  
Tissue Type ◽  
External Carotid ◽  
Digital Subtraction ◽  
Triphenyltetrazolium Chloride

Abstract In an effort to determine the value of tissue-type plasminogen activator (TPA) in the treatment of embolic stroke, 17 rabbits were subjected to a model of embolic stroke in which 2-hour-old, tin-impregnated, autologous clots were embolized to the bifurcation of the internal carotid artery at the circle of Willis via retrograde injection into the cannulated external carotid artery. High-resolution digital subtraction radiography was used to localize clots intracranially at the carotid bifurcation. Circulation through the internal carotid artery and intracranial vessels was monitored with serial digital subtraction angiography before and after embolization and during treatment. Disappearance of the tin marker on the digital subtraction radiograph indicated dissolution of clot and was associated with reestablishment of circulation on the digital subtration angiogram. Experimental animals were treated with human-specific recombinant TPA 30 minutes, 2 hours, or 4 hours after clot embolization. TPA was administered as an intravenous bolus of 0.5 mg/kg followed by an infusion of 1 mg/kg/h for 2 hours. Digital subtraction angiograms were performed every 30 minutes. All clots dissolved, and cerebral circulation was reestablished within 120 minutes of treatment. In control animals treated with saline, embolized clots were stable, and the internal carotid artery remained occluded. At the completion of each study, the animal was perfused with freshly prepared, buffered 2,3,5-triphenyltetrazolium chloride (TTC) for demarcation of cerebral infarction. Control animals demonstrated infarction of 50 ± 3.6% of the ipsilateral cerebral hemisphere, with an infarct weight of 2.1 ± 0.2 g. The weight of cerebral infarction, as defined by the failure of tissue to stain with TTC, was reduced significantly in TPA-treated animals (P < 0.01). Treatment begun 30 minutes after clot embolization resulted in the most pronounced reduction in cerebral infarction. No intracerebral bleeding was observed. Results indicate that treatment with TPA is effective in dissolving embolic clots and reestablishing intracranial circulation. For best protection against cerebral infarction, however, treatment should be started as soon as possible.

scholarly journals Preoperative surgical planning for an internal carotid artery invading brain tumor

2020 ◽  
Vol 3 (2) ◽  
pp. 46-49
Author(s):  
Hendrikus Bolly ◽  
Bilzardy Ferry Zulkifli ◽  
Achmad Adam
Keyword(s):  
Brain Tumor ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Tumor Cells ◽  
Surgical Planning ◽  
Tumor Tissue ◽  
Internal Carotid ◽  
Preoperative Planning ◽  
Basic Mechanism ◽  
Patient’S Outcome

Brain tumor such as a meningioma can invade the adjacent internal carotid artery (ICA). Surgical approach to resect the tumor has to consider the level of ICA and how the depth of tumor cells invade into the artery layer. Knowledge of the basic mechanism about how the tumor cells invade the lumen and layer of the vessels is essential in perioperative preparation. Here we reported our unpredictable case findings of transient intraluminal obstruction of the arterial wall by tumor tissue in angiography examination as well as preoperative planning to resect the tumor and predictors of the patient’s outcome.

scholarly journals Ruptured dissecting aneurysm in communicating internal carotid artery segments treated using a stent-assisted endovascular technique

2018 ◽  
Vol 24 (2) ◽  
pp. 130-134 ◽  
Author(s):  
Chae Wook Huh ◽  
Sung-Chul Jin
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Glasgow Outcome Scale ◽  
Internal Carotid ◽  
Neurological Complications ◽  
Dissecting Aneurysm ◽  
Digital Subtraction ◽  
Endovascular Technique ◽  
Dissecting Aneurysms

Hemorrhagic intracranial dissecting aneurysms are known to have a poor natural history and an increased tendency to rebleed. The communicating segment of the internal carotid artery (ICA) is an infrequent site of dissection that is difficult to manage using deconstructive endovascular treatment because of the need to preserve important vascular branches. We report two cases of ruptured dissecting aneurysms that occurred in communicating segments of the ICA and treated using a reconstructive endovascular technique involving stent-assisted coiling. Case 1 was a 59-year-old woman who was diagnosed with subarachnoid hemorrhage (SAH). Digital subtraction angiography (DSA) indicated a ruptured dissecting aneurysm that arose from the left communicating segment of the ICA. Stent-assisted coiling was performed and followed by a second overlapping stent technique. No deterioration was observed on DSA after one week of follow-up or on magnetic resonance angiography (MRA) after four months of follow-up. The patient was discharged without neurological complications (Glasgow Outcome Scale 5). Case 2 was a 34-year-old man who was admitted with a diagnosis of SAH. DSA revealed a suspected lesion of a ruptured dissecting aneurysm of the left communicating segment of the ICA. Stent-assisted coiling was performed, and partial occlusion was achieved. No deterioration was observed on DSA after two weeks of follow-up or on MRA after six months of follow-up. The patient was discharged without neurological complications (Glasgow Outcome Scale 5). These cases suggest that using stent-assisted coiling could be a feasible modality for treating ruptured ICA dissecting aneurysms in the communicating segment.

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