scholarly journals A symptomatic atherosclerotic persistent pharyngo-hyo-stapedial artery: Treatment management and embryological considerations

2020 ◽  
Vol 26 (5) ◽  
pp. 675-680
Author(s):  
Federico Cagnazzo ◽  
Riccardo Zannoni ◽  
Pierre-Henri Lefevre ◽  
Cyril Dargazanli ◽  
Imad Derraz ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Carotid Artery ◽  
Internal Carotid ◽  
External Carotid Artery ◽  
External Carotid ◽  
Digital Subtraction ◽  
Transient Ischemic Attacks ◽  
Unique Case ◽  
Stapedial Artery

The stapedial artery (SA) is an embryonic vessel connecting the internal carotid artery (ICA) to the branches of the future external carotid artery (ECA). It passes through the primordium of the stapes that progressively develops around the SA. Normally, SA disappears during the tenth week in utero. Approximately 0.4% of the population can have a persistent SA. It can persist as four types of embryological variations, of which the pharyngo-hyo-stapedial variant has been rarely described before. We reported a case of a 61-year-old woman presented with transient ischemic attacks (TIAs). Computed tomography angiography showed an unusual “duplicated” aspect of the left ICA. Digital subtraction angiography depicted a persistent pharyngo-hyo-stapedial artery with an atherosclerotic wall and was considered the cause of the TIAs. After failure of the antiplatelet therapy in preventing recurrent TIAs, stenting of the artery was planned and successfully performed. Patient was asymptomatic during 12-month follow-up. The pharyngo-hyo-stapedial artery is a very rare variation in which the SA is supplied by the inferior tympanic (rising from the ascending pharyngeal artery) and the hyoid artery (rising from the ICA). To our knowledge, this is a unique case of a pharyngo-hyo-stapedial artery in a patient presenting associated ischemic symptoms. Radiological and embryological findings are discussed.

Bilateral External Carotid Artery Aneurysms

Vascular ◽  
2004 ◽  
Vol 12 (6) ◽  
pp. 387-389 ◽  
Author(s):  
Vladimir Grigoryants ◽  
Matthew J. Eagleton ◽  
Gilbert R. Upchurch
Keyword(s):  
Computed Tomography ◽  
Cerebral Ischemia ◽  
Carotid Artery ◽  
Physical Examination ◽  
Cranial Nerve ◽  
External Carotid Artery ◽  
External Carotid ◽  
Local Pain ◽  
Neck Masses

A 60-year-old female was found on a physical examination to have bilateral palpable pulsatile neck masses. She denied local pain, cranial nerve compressive symptoms, or symptoms of cerebral ischemia. Duplex ultrasonography demonstrated bilateral 1.5 x 2.2 cm external carotid artery aneurysms. Isolated bilateral external carotid artery aneurysms were confirmed by computed tomography and angiography. The patient has been treated conservatively, and at 4-year follow-up, she remains asymptomatic, and the carotid artery aneurysms are unchanged in size.

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.

scholarly journals External Carotid Artery Stenting to Treat Patients With Symptomatic Ipsilateral Internal Carotid Artery Occlusion

Neurosurgery ◽  
2010 ◽  
Vol 67 (2) ◽  
pp. 314-321 ◽  
Author(s):  
David S. Xu ◽  
Todd A. Abruzzo ◽  
Felipe C. Albuquerque ◽  
Guilherme Dabus ◽  
Mark K. Eskandari ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Neurological Status ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
External Carotid Artery ◽  
External Carotid ◽  
Presenting Symptoms

Abstract BACKGROUND The external carotid artery (ECA) anastomoses in many distal territories supplied by the internal carotid artery (ICA) and is an important source of collateral circulation to the brain. Stenosis of the ECA in ipsilateral ICA occlusion can produce ischemic sequelae. OBJECTIVE To examine the effectiveness of ECA stenting in treating symptomatic ipsilateral ICA occlusion. METHODS We retrospectively reviewed patient databases from 5 academic medical centers to identify all individuals who underwent ECA stenting after 1998. For all discovered cases, coinvestigators used a common submission form to harvest relevant demographic information, clinical data, procedural details, and follow-up results for further analysis. RESULTS Twelve patients (median age, 66 years; range, 45–79 years) were identified for our cohort. Vessel disease involvement included severe ECA stenosis ≥ 70% in 11 patients and ipsilateral ICA occlusion in all patients. Presenting symptoms included signs of transient ischemic attack, stroke, and amaurosis fugax. ECA stenting was associated with preservation of neurological status in 11 patients and resolution of symptoms in 5 patients at a median follow-up time of 26 months (range, 1–87 months; mean, 29 months). Symptomatic in-stent restenosis did not occur within any patient during the follow-up course. CONCLUSION We found ECA stenting in symptomatic ipsilateral ICA disease to be a potentially effective strategy to preserve neurological function and to relieve ischemic symptoms. Further investigation with larger studies and longer follow-up periods is warranted to elucidate the true indications of this management strategy.

scholarly journals Variant ascending pharyngeal artery maintaining flow in a subocclusive internal carotid artery

2019 ◽  
Vol 12 (8) ◽  
pp. e230048
Author(s):  
Brian D Kim ◽  
Thomas J Oxley ◽  
Johanna T Fifi ◽  
Hazem Shoirah
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Recurrent Events ◽  
Internal Carotid ◽  
External Carotid Artery ◽  
External Carotid ◽  
Sustained Improvement ◽  
Therapeutic Implications ◽  
Ascending Pharyngeal Artery

Ectopic branches of the external carotid artery are rare but have critical diagnostic and therapeutic implications. We present a case involving a 70-year-old man who presented with recurrent left hemispheric strokes in the setting of a subocclusive left internal carotid stenosis. A left ascending pharyngeal artery with variant origin from the internal carotid artery helped maintain flow distal to the area of stenosis and allowed for safe and successful internal carotid artery stenting. Identification of this variant and recognition of the anastomotic network involving this connection were crucial to determine the safety of stenting. The patient had no further recurrent events and had sustained improvement on his 90-day follow-up.

Treatment of a rare and complex carotid-cavernous fistula

2021 ◽  
Vol 14 (3) ◽  
pp. e240596
Author(s):  
Arunit J S Chugh ◽  
Yifei Duan ◽  
Yin C Hu
Keyword(s):  
Carotid Artery ◽  
Classification System ◽  
Internal Carotid ◽  
External Carotid Artery ◽  
Arterial Supply ◽  
External Carotid ◽  
Coil Embolisation ◽  
Unique Case ◽  
Carotid Cavernous Fistulas ◽  
Supply Pattern

Carotid-cavernous fistulas (CCFs) are abnormal connections between arteries and the cavernous sinuses. Traditionally, the Barrow Classification system has been used to characterise these fistulas based on their arterial supply from the internal carotid artery (ICA), external carotid artery (ECA) or both. We present a unique case of a patient with a complex CCF with arterial feeders from dural branches of the ECA, ICA and vertebral artery (VA), which, to our knowledge, has not been reported in the literature. Given unique arterial supply pattern involving contribution from the extracranial VA, this CCF falls outside of the traditional Barrow Classification system. The patient ultimately underwent a transfemoral transvenous coil embolisation using multiple dynamic venous routes with obliteration of bilateral CCFs and near complete resolution of her preoperative symptoms.

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