Clinical case of successful combined emergency reconstructive surgery of the internal carotid artery, with its acute dissection and coronary bypass surgery

2018 ◽  
Vol 19 (6) ◽  
pp. 856-862 ◽  
Author(s):  
I.Yu. Sigaev ◽  
M.V. Shumilina ◽  
N.A. Darvish ◽  
A.V. Kazaryan
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Reconstructive Surgery ◽  
Clinical Case ◽  
Bypass Surgery ◽  
Internal Carotid ◽  
Coronary Bypass ◽  
Coronary Bypass Surgery ◽  
Acute Dissection

Retinal macroaneurysm after carotid endarterectomy in patient with chronic ischemic retinopathy associated with hemodynamically significant stenosis of the internal carotid artery (clinical case)

2021 ◽  
pp. 274-277
Author(s):  
V.V. Tuzlaev ◽  
◽  
O.V. Kolenko ◽  
V.V. Egorov ◽  
I.Z. Kravchenko ◽  
...  
Keyword(s):  
Blood Flow ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Carotid Endarterectomy ◽  
Clinical Case ◽  
Internal Carotid ◽  
Significant Stenosis ◽  
Ischemic Retinopathy ◽  
Retinal Macroaneurysm ◽  
Intraretinal Hemorrhages

Purpose. To present a clinical case of development of retinal macroaneurysm after carotid endarterectomy (CE) in patient with chronic ischemic retinopathy (CIR) associated with hemodynamically significant stenosis of the internal carotid artery (ICA). Material and methods. Patient R., 74 years old, diagnosed with CIR of the 1st degree of severity of the right eye. In addition to standard ophthalmic examination methods, Doppler ultrasound with registration of blood flow in the orbital artery and spiral computed tomography of the ICA were performed. Results. Panretinal photocoagulation (PRP) of the retina led to obliteration of the retinal macroaneurysm, resorption of intraretinal hemorrhages, and stabilization of the course of CIR after CE of the ICA. Conclusion. The appearance of retinal macroaneurysm and intraretinal hemorrhages after CE in patient with CIR associated with hemodynamically significant ICA stenosis can be regarded as reperfusion complications after restoration of blood flow in the orbital artery, which requires timely retinal PRP of the retina. Key words: chronic ischemic retinopathy, retinal macroaneurysm, internal carotid artery, carotid endarterectomy.

scholarly journals Reconstructive surgery for segmental arterial mediolysis involving both the internal carotid artery and visceral arteries

2006 ◽  
Vol 43 (3) ◽  
pp. 623-626 ◽  
Author(s):  
Hideaki Obara ◽  
Kenji Matsumoto ◽  
Yoshiaki Narimatsu ◽  
Hitoshi Sugiura ◽  
Masaki Kitajima ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Reconstructive Surgery ◽  
Internal Carotid ◽  
Segmental Arterial Mediolysis ◽  
Visceral Arteries

Spontaneous Acute Dissection of the Internal Carotid Artery

2006 ◽  
Vol 41 (2) ◽  
pp. 105-111 ◽  
Author(s):  
Rainald Bachmann ◽  
Isabelle Nassenstein ◽  
Hendrik Kooijman ◽  
Ralf Dittrich ◽  
Harald Kugel ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Acute Dissection

scholarly journals Quantitative assessment of changes in hemodynamics of the internal carotid artery after bypass surgery for moyamoya disease

2018 ◽  
Vol 129 (3) ◽  
pp. 677-683 ◽  
Author(s):  
Fengping Zhu ◽  
Yi Qian ◽  
Bin Xu ◽  
Yuxiang Gu ◽  
Kaavya Karunanithi ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Moyamoya Disease ◽  
Mr Angiography ◽  
Bypass Surgery ◽  
Internal Carotid ◽  
Vessel Diameter ◽  
Hemodynamic Changes ◽  
Quantitative Mr ◽  
Vessel Remodeling

OBJECTIVEAlthough intracranial vessel remodeling has been observed in moyamoya disease, concerns remain regarding the effect of bypass surgery on hemodynamic changes within the internal carotid artery (ICA). The authors aimed to quantify the surgical effect of bypass surgery on bilateral ICAs in moyamoya disease and to estimate pressure drop (PD) along the length of the ICA to predict surgical outcomes.METHODSRecords of patients who underwent bypass surgery for treatment of moyamoya disease and in whom flow rates were obtained pre- and postsurgery by quantitative MR angiography were retrospectively reviewed. Quantitative MR angiography and computational fluid dynamics were applied to measure morphological and hemodynamic changes during pre- and postbypass procedures. The results for vessel diameter, volumetric flow, PD, and mean wall shear stress along the length of the ICA were analyzed. Subgroup analysis was performed for the circle of Willis (CoW) configurations.RESULTSTwenty-three patients were included. The PD in ICAs on the surgical side (surgical ICAs) decreased by 21.18% (SD ± 30.1%) and increased by 11.75% (SD ± 28.6%) in ICAs on the nonsurgical side (contralateral ICAs) (p = 0.001). When the PD in contralateral ICAs was compared between patients with a complete or incomplete CoW, the authors found that the PDI in the former group decreased by 2.45% and increased by 20.88% in the latter (p = 0.05). Regression tests revealed that a greater postoperative decrease in PD corresponded to shrinking of ICAs (R2 = 0.22, p = 0.02).CONCLUSIONSPD may be used as a reliable biomechanical indicator for the assessment of surgical treatment outcomes. The vessel remodeling characteristics of contralateral ICA were related to CoW configurations.

scholarly journals Kinking of the internal carotid artery in otorhinolaryngologist’s practice

2021 ◽  
Author(s):  
O. V. Zeleva ◽  
P. M. Zelter ◽  
A. V. Tsoy ◽  
M. N. Myakotnyh
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Clinical Case ◽  
Internal Carotid ◽  
Vascular Surgeon

Аnomalies of internal carotid artery can occur not only in the practice of vascular surgeon, but also in other specialties. This article discusses a clinical case in the practice of an otorhinolaryngologist kinking of the internal carotid artery, which simulated pathology of pharynx. 

scholarly journals Pseudostroke as a manifestation of mediastinal choriocarcinoma in an elderly man

2021 ◽  
Vol 15 (4) ◽  
pp. 93-98
Author(s):  
Yuliya S. Korneva ◽  
Natalya N. Maslova ◽  
Yana A. Rudenko ◽  
Maxim A. Miloserdov ◽  
Oksana A. Shisterova
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Lymph Node ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Clinical Case ◽  
Internal Carotid ◽  
Neurological Symptoms ◽  
Carotid Artery Compression ◽  
Lymph Node Secondary

We describe a rare clinical case: onset of acute neurological symptoms suggestive of a pesudostroke, caused by an imbalance in cerebral blood flow as a result of internal carotid artery compression by an enlarged lymph node secondary to metastases from a disseminated non-gestational mediastinal choriocarcinoma. This was accompanied by decompensation due to paraneoplastic coagulopathy.

Is Carotid Artery Stenting an Alternative to Simultaneous Carotid Endarterectomy Performed for Carotid Artery Stenosis in Patients Undergoing Isolated Coronary Bypass Surgery?

2015 ◽  
Vol 18 (5) ◽  
pp. 211 ◽  
Author(s):  
Hüseyin Şaşkın ◽  
Cagri Duzyol ◽  
Kazım Serhan Ozcan ◽  
Rezan Aksoy ◽  
Mustafa Idiz
Keyword(s):  
Myocardial Infarction ◽  
Cardiopulmonary Bypass ◽  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Carotid Artery Stenting ◽  
Bypass Surgery ◽  
Coronary Bypass ◽  
Coronary Bypass Surgery ◽  
Group 2 ◽  
Group 1

<strong>Background:</strong> Treatment method in patients with coronary artery disease undergoing coronary bypass surgery with accompanying carotid artery disease is still a hot topic among clinicians. This study is designed to investigate if there is an effect on myocardial infarction, cerebrovascular events and mortality during postoperative period of simultaneous carotid endarterectomy with coronary bypass surgery compared to staged carotid artery stenting before coronary bypass surgery.<br /><strong>Methods:</strong> 102 patients (79 male, 23 female) who underwent simultaneous carotid endarterectomy with coronary bypass surgery or staged carotid artery stenting with coronary bypass surgery in the same center with the same surgical team were divided into 2 groups and retrospectively reviewed. Group 1 (n = 71) had coronary artery bypass surgery under general anesthesia with carotid endarterectomy followed by cardiopulmonary bypass with heart team decision. Again with heart team decision, Group 2 (n=31), patients at high-risk for carotid endarterectomy (serious cardiac disease, severe chronic obstructive pulmonary disease, superiorly located lesions), received carotid artery stents in the interventional radiology department and a month later, coronary bypass surgery was performed with cardiopulmonary bypass under elective conditions.<br /><strong>Results:</strong> Median of patient age was 67.5 (45-83) years. Twenty-two patients (31%) in Group 1 and 19 patients (56.3%) in Group 2 had neurological symptoms, which was statistically significant (P = .004). During the early postoperative term, three patients (4.2%) in Group 1 and two patients (6.5%) in Group 2 died (P = .64). Five patients (7.0%) in Group 1 and two patients (6.5%) in Group 2 developed neurological symptoms during the early postoperative term <br />(P &gt; .05). Likewise, two patients (2.8%) in Group 1 and five patients (16.1%) in Group 2 developed myocardial infarction following carotid intervention (P = .03).<br /><strong>Conclusions:</strong> In patients with significant carotid artery stenosis undergoing coronary bypass surgery with cardiopulmonary bypass, in comparison to simultaneous carotid endarterectomy with coronary bypass technique and carotid artery stenting followed with coronary bypass technique showed no difference in combined endpoint (postoperative myocardial infarction, neurological events, and mortality). With proper tools and according to the decisions made by heart teams, both management strategies can be safely performed.<br /><br />

Blood blisterlike aneurysms of the internal carotid artery

1998 ◽  
Vol 89 (3) ◽  
pp. 419-424 ◽  
Author(s):  
Masamitsu Abe ◽  
Kazuo Tabuchi ◽  
Hiroaki Yokoyama ◽  
Akira Uchino
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Bypass Surgery ◽  
Internal Carotid ◽  
Clinical Course ◽  
Fibrous Tissue ◽  
Anterior Wall ◽  
Autopsy Study ◽  
Content Type ◽  
Fine Print

Object. An aneurysm arising from the anterior wall of the internal carotid artery (ICA) is a poorly understood entity. A small hemispherical bulge from the anterior wall of the ICA, which is called a “blood blisterlike aneurysm” (BBA), may be confused with a tiny berry aneurysm although the clinical features are distinctly different. This paper summarizes the clinical course of patients with this lesion to clarify the nature of the BBA. Methods. Six patients with BBAs who presented with subarachnoid hemorrhage (SAH) are described. In all patients, the initial angiogram obtained soon after SAH showed only a small bulge from the anterior wall of the ICA. In three of the six patients this bulge had progressed to a saccular appearance within a few weeks. The wall of the lesion was so thin and fragile that the aneurysm ruptured at the base during clipping or within a few hours after clipping in two patients. Conclusions. From the authors' experience, as well as a review of the literature, which includes an autopsy study of similar cases, it is inferred that these lesions are focal wall defects covered only with thin fibrous tissue and that they are therefore not true aneurysms. Direct clipping often causes laceration of the lesion, whereas complete wrapping or clipping after wrapping is effective, but may fail to prevent growth of the aneurysm. Endovascular occlusion of the cervical ICA with or without bypass surgery, which is less risky than direct surgery, is another option.

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