Elongated internal carotid arteries in patients with severe carotid artery stenosis.

2021 ◽  
Vol 19 ◽  
Author(s):  
Tomoaki Tamada ◽  
Toshio Imaizumi ◽  
Shoichi Komura ◽  
Tatsufumi Nomura ◽  
Aya Kanno ◽  
...  

Objective: To investigate the risk factors and asymptomatic cerebrovascular diseases associated with elongated internal carotid arteries (ICAs), and the relationship between ICA elongation and severe carotid artery (CA) stenosis Methods: We evaluated risk factors for stroke and magnetic resonance imaging (MRI) findings in patients with severe CA stenosis compared with people without neurological disorders who underwent brain screening (controls). On Magnetic resonance angiography (MRA) images we measured the longest distance, defined as the ICA distance, from the most distant anterior wall of the cervical ICA at the site of bending or kinking to the line between the origin of the external CA and the anterior protrusion of the ICA near the petrosal bone. We retrospectively compared various asymptomatic findings, including cerebral microbleeds, lacunar infarctions, and deep white matter hyperintensities (WMHs), between participants with an ICA distance ≥ 1.2 cm vs. < 1.2 cm. The prevalence of findings and stroke risk factors were compared using multivariate logistic regression models. Results: We evaluated 53 patients (70.0 ± 8.1 years old, nine female) with severe CA stenosis treated by CA stenting and 400 controls (63.0 ± 9.2 years old, 227 females). Multivariate analyses showed that ICA distance ≥ 1.2 cm was associated with age ≥ 65 years (odds ratio [OR] = 1.8, p < 0.01), severe deep WMHs (OR = 2.0, p = 0.02), and severe CA stenosis (OR = 0.17, p < 0.01). Conclusion: ICA elongation, measured by ICA distance, was positively associated with age and deep WMHs and negatively associated with severe CA stenosis.

2009 ◽  
Vol 123 (12) ◽  
pp. 1331-1337 ◽  
Author(s):  
H G Hatipoglu ◽  
M A Cetin ◽  
A Selvi ◽  
E Yuksel

AbstractObjective:This study aimed to determine whether magnetic resonance imaging has a role in the evaluation of the sphenoid sinus and internal carotid artery. In addition, we aimed to establish reference measurements for the minimal distance between the internal carotid arteries.Method:The sphenoid sinuses and neighbouring internal carotid arteries of 90 patients were evaluated using sagittal T1-weighted and axial and coronal T2-weighted magnetic resonance images.Results:Sphenoid sinus pneumatisation was categorised as occipitosphenoidal (0 per cent), conchal (3.3 per cent), presellar (14.4 per cent) or sellar (82.2 per cent). The internal carotid artery protruded into the sphenoid sinus in 32.8 per cent, with a septum in 9.4 per cent. The incidence of sellar-type sphenoid sinus pneumatisation was higher in patients with protrusion of the internal carotid artery into the sphenoid sinus (p < 0.001). The incidence of presellar pneumatisation was higher in patients without internal carotid artery protrusion (p < 0.001). The minimal distance between the internal carotid arteries varied between 9.04 and 24.26 mm (mean, 15.94 mm).Conclusion:Magnetic resonance imaging can provide useful information about the sphenoid sinus and internal carotid artery, prior to endoscopic sphenoidotomy and trans-sphenoidal hypophysectomy.


Author(s):  
Gabriel Zada ◽  
M. Beatriz S. Lopes ◽  
Srinivasan Mukundan ◽  
Edward Laws

1979 ◽  
Vol 50 (6) ◽  
pp. 747-757 ◽  
Author(s):  
Roger W. Countee ◽  
Thurairasah Vijayanathan

✓ The authors describe their experiences with five patients with delayed transient ischemic symptoms homolateral to internal carotid artery (ICA) occlusions. In each instance, initial arteriograms were interpreted as showing irreversible occlusions of these arteries in the neck and microvascular bypass procedures were contemplated. However, after repeat arteriographic evaluations with a modified injection technique, certain angiographic features were identified that suggested the mechanism of the symptoms in these patients and that their ICA's could be reconstituted in the neck. This was successfully accomplished in each patient with complete relief of ischemic symptoms. The angiographic technique employed and the arterial flow patterns identified in these patients are discussed. The details of the operative technique are described. It is concluded that routine arteriographic techniques may be inadequate to identify the reversible carotid occlusion. This may account for some of the confusion which surrounds the surgery of these vessels as well as the failure of extracranial-intracranial bypass to relieve recurrent ischemic symptoms in these individuals.


2010 ◽  
Vol 124 (9) ◽  
pp. 1033-1036 ◽  
Author(s):  
S Hosokawa ◽  
H Mineta

AbstractBackground:Deformities of the carotid artery are rare. Tortuosity, kinking and coiling of the internal carotid artery may be observed with advancing age. A tortuous internal carotid artery may cause an abnormal sensation in the throat. In the early twentieth century, there were several reported cases of fatal haemorrhage during pharyngeal surgical procedures, because this condition went undetected.Method and results:We present two cases of tortuosity of the right internal carotid artery. Both women complained of abnormal throat sensations. Endoscopic studies and radiological examinations revealed tortuous right internal carotid arteries presenting as pulsatile masses. A literature review revealed that, in most reported cases, this deformity occurred on the right side. We believe that the defect and its right-sided predominance can be attributed to anatomical influences and factors affecting blood pressure.Conclusion:In most reported cases of tortuous internal carotid artery, the defect occurred on the right side and patients complained of an abnormal sensation in the throat. This information is useful in the diagnosis of this condition. It is important for otolaryngologists to recognise this anomaly, because fatal haemorrhage can occur in patients with this condition during surgical procedures on the pharynx.


2005 ◽  
Vol 38 (02) ◽  
pp. 170-171
Author(s):  
S B Rao ◽  
V R Vollala ◽  
M Rao ◽  
V P Samuel ◽  
D Deepthinath ◽  
...  

AbstractThe arterial pattern of the human body is one of the systems that show a large number of variations. Many reports are available regarding variations of common carotid, external and internal carotid arteries and branches of external carotid artery. We describe a very rare case of lateral position of external carotid artery. The external carotid artery was lateral to the internal carotid artery at the bifurcation of the common carotid artery. The clinical importance of this variation is discussed.


1979 ◽  
Author(s):  
Charles Warlow ◽  
Peter Fish

The accuracy, and possible clinical application of non-invasive ultra sound imaging of the cervical carotid, artery in patients with cerebrovascular disease has been investigated by comparing a pulsed multi-channel directional Doppler imaging devise (“MAVIS” - GEC Medical) with conventional carotid angiography. Of 23 normal or minimally diseased internal carotid arteries only 4 appeared as stenosed on Doppler angiography, the other 19 were normal; of 14 stenosed arteries only 1 appeared normal on imaging,1 appeared occluded end 12 showed clear images of stenosis; all 6 occluded arteries appeared occluded on ultra sound imaging. It was difficult to obtain satisfactory images of the external carotid arteries in all cases. The additional facility to display a velocity flow profile at preselected points along the arterialimage should increase the usefulness of this technique, particularly when there is only minor atheromatous irregularity or ulceration, and such a device will be briefly disrussed.


2011 ◽  
Vol 17 (1) ◽  
pp. 22-26
Author(s):  
H.-C. Chen ◽  
C.-J. Lin ◽  
F.-C. Chang ◽  
C.-B. Luo ◽  
Y.-J. Lai ◽  
...  

Collateral networks between the external carotid artery and internal carotid arteries become crucial for cerebral perfusion after occlusion of internal carotid arteries. We report the first case of a patient who received percutaneous transluminal angioplasty and stenting in a collateral vessel between the external and internal carotid artery for treatment of radiation induced severe stenosis of the internal carotid artery in the context of a contralateral internal carotid artery occlusion.


2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Gary G. Tse ◽  
Elna M. Masuda ◽  
Aaron M. McMurtray ◽  
Beau K. Nakamoto

The risk of stroke and management of coiling of the cervical internal carotid artery in the absence of an atherosclerotic carotid bulb lesion is unclear. We report a case of an otherwise healthy 39-year-old woman who developed bilateral sequential strokes associated with bilateral coiled internal carotid arteries. We discuss the risk of stroke and management of coiled carotid arteries as they relate to the patient presented.


2018 ◽  
Vol 24 (4) ◽  
pp. 179-183
Author(s):  
Vărgău Iulia ◽  
Bordei Petru ◽  
Ispas Viorel

Abstract The study of CT angiographies performed on a CT scanner GE LightSpeed VCT16 Slice CT revealed some morphological features of the ophthalmic artery related to origin, morphometry and the internal carotid arteries in the vicinity of this artery. The diameter of the left internal carotid artery under the origin of the ophthalmic artery was between 4.0-5.8 mm and that of the right ophthalmic artery at the same level was between 4.1-5.3 mm. Under the origin of the ophthalmic artery, the internal carotid arteries were larger in diameter on the leftside in 80% of cases, with differences of 0.1-0.3 mm, and on the right side these differences were between 0.1-0.2 mm, 20% of cases. The diameter of the left internal carotid artery above the origin of the ophthalmic artery was 3.7-5.0 mm, and the origin of the right carotid artery at the same level was 3.8-5.0 mm.


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