Intracranial vascular anastomosis using the microanastomotic system

1998 ◽  
Vol 89 (4) ◽  
pp. 676-681 ◽  
Author(s):  
David W. Newell ◽  
Andrew T. Dailey ◽  
Stephen L. Skirboll
Keyword(s):  
Internal Carotid ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Collateral Flow ◽  
Content Type ◽  
History Of ◽  
End To End ◽  
Fine Print

✓ The authors describe the use of a microanastomotic device to perform intracranial end-to-end vascular anastomoses. Direct end-to-end anastomosis was performed between the superficial temporal artery and branches of the middle cerebral artery (MCA) in three patients. Two patients had moyamoya disease, with severe proximal MCA disease, and one suffered an internal carotid artery occlusion with poor collateral flow. All patients reported a history of recent ischemic symptoms. Each anastomosis was accomplished in less than 15 minutes with technically satisfactory results. Postoperative angiographic studies demonstrated patency of the bypasses in all patients.

Aneurysm of the ICA petrous segment treated by balloon entrapment after EC-IC bypass

1986 ◽  
Vol 65 (2) ◽  
pp. 249-252 ◽  
Author(s):  
Kevin M. McGrail ◽  
Roberto C. Heros ◽  
Gerard Debrun ◽  
Brian D. Beyerl
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Superficial Temporal Artery ◽  
Cranial Nerves ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Preliminary Evaluation ◽  
Content Type ◽  
Fine Print

✓ A 44-year-old man experienced the sudden onset of horizontal diplopia and hemifacial numbness. Arteriography demonstrated a left intrapetrous carotid artery aneurysm. The patient was successfully treated with a left superficial temporal artery to middle cerebral artery bypass followed by balloon entrapment of the aneurysm. There have been at least 40 previously reported cases of aneurysms of the petrous portion of the carotid artery. These aneurysms can be mycotic, traumatic, or developmental in origin. They can present with massive otorrhagia or epistaxis from acute rupture or with decreased hearing and paresis of the fifth through eighth cranial nerves and, less frequently, of the ninth, 10th, and 12th cranial nerves caused by direct pressure. They can also produce pulsatile tinnitus, and sometimes they are discovered as a retrotympanic vascular mass during otological examination. The treatment of choice is carotid artery occlusion. Trapping of the aneurysm by detachable balloons eliminates immediately the risk of hemorrhage, offers the possibility of test occlusion of the internal carotid artery with the patient awake prior to permanent occlusion, and should also reduce the risk of thromboembolism. It should be preceded by a bypass procedure when preliminary evaluation indicates that the patient will not tolerate internal carotid artery occlusion.

Resolution of occlusion in spontaneously dissected carotid arteries

1982 ◽  
Vol 56 (6) ◽  
pp. 857-860 ◽  
Author(s):  
Eugenio Pozzati ◽  
Giulio Gaist ◽  
Massimo Poppi
Keyword(s):  
Carotid Arteries ◽  
Internal Carotid ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Spontaneous Resolution ◽  
Transient Ischemic Attacks ◽  
Content Type ◽  
Antiplatelet Aggregation ◽  
Spontaneous Dissection ◽  
Fine Print

✓ Two cases of internal carotid artery occlusion secondary to spontaneous dissection are reported. Both patients presented with transient ischemic attacks. Both had antiplatelet aggregation therapy, followed by spontaneous resolution of the occlusion. The period of healing seems to be relatively short. In both cases, restoration of flow was angiographically documented 14 days and 10 weeks after the initial arteriogram. Strategies for treatment of such patients are discussed.

Hypoplastic internal carotid artery mimicking a classic angiographic “string sign”

1997 ◽  
Vol 86 (3) ◽  
pp. 567-570 ◽  
Author(s):  
Jason A. Heth ◽  
Christopher M. Loftus ◽  
John G. Piper ◽  
William Yuh
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Transient Ischemic Attacks ◽  
Associated Anomalies ◽  
Content Type ◽  
String Sign ◽  
Fine Print

✓ The authors report the case of a patient with transient ischemic attacks who was evaluated by duplex scanning, which demonstrated total carotid artery occlusion. Arteriography revealed what appeared to be a classic “string sign” in the cervical carotid artery, and a standard endarterectomy was planned. At surgery the internal carotid artery was found to be congenitally atretic, accounting for the string appearance of the arteriogram. The etiology, associated anomalies, differential diagnosis, and diagnostic evaluation of such lesions are discussed.

Pituitary apoplexy associated with a triple bolus test

1984 ◽  
Vol 61 (3) ◽  
pp. 586-590 ◽  
Author(s):  
Mark Bernstein ◽  
Robert A. Hegele ◽  
Fred Gentili ◽  
Michael Brothers ◽  
Richard Holgate ◽  
...  
Keyword(s):  
Carotid Arteries ◽  
Internal Carotid ◽  
Pituitary Apoplexy ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Content Type ◽  
Clinical Recovery ◽  
Preoperative Test ◽  
Unique Aspect ◽  
Fine Print

✓ The authors report a case of pituitary apoplexy resulting in bilateral internal carotid artery occlusion, with marked depression of consciousness and hemiplegia. After transsphenoidal tumor decompression, restoration of flow in both carotid arteries was documented angiographically and the patient made an excellent clinical recovery. The unique aspect of this case is that the pituitary apoplexy was apparently precipitated by neuroendocrine manipulation, performed as a preoperative test of pituitary function.

Moyamoya disease as a cause of subarachnoid hemorrhage in a Negro patient

1976 ◽  
Vol 44 (5) ◽  
pp. 620-622 ◽  
Author(s):  
Robert P. Meriwether ◽  
Hugh G. Barnett ◽  
Dean H. Echols
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Moyamoya Disease ◽  
Internal Carotid ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Content Type ◽  
Arterial Network ◽  
Japanese Word ◽  
Negro Patient ◽  
Fine Print

✓ The authors describe a case of subarachnoid hemorrhage secondary to moyamoya disease in an adult Negro. To the authors' knowledge, this is the first such case reported. Moyamoya, the Japanese word for “puff of smoke,” describes the characteristic angiographic appearance of the collateral arterial network associated with internal carotid artery occlusion. The cause is unknown. Treatment consists of supportive care; the prognosis is variable.

Treatment of bilateral mycotic intracavernous carotid aneurysms

1982 ◽  
Vol 56 (3) ◽  
pp. 443-447 ◽  
Author(s):  
Tsuneyoshi Eguchi ◽  
Tadayoshi Nakagomi ◽  
Akira Teraoka
Keyword(s):  
Internal Carotid ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Systemic Blood Pressure ◽  
Neurological Deficits ◽  
Systemic Blood ◽  
Content Type ◽  
Carotid Aneurysms ◽  
The Right ◽  
Fine Print

✓ A case of bilateral mycotic intracavernous carotid aneurysms is reported. Because of progressive bilateral ophthalmoplegia, the internal carotid artery (ICA) was ligated on both sides, combined with bilateral extracranial-intracranial arterial bypass. A superficial temporal artery-middle cerebral artery anastomosis was performed first on the right side followed by ligation of the right ICA at the neck. After an interval of 20 days, a bypass and ICA ligation was carried out on the left side. The patient developed mild hemiparesis and dysphasia during and immediately after the second operation, but these neurological deficits disappeared after elevation of systemic blood pressure.

scholarly journals Patients Receiving Extracranial to Intracranial Bypass for Atherosclerotic Vessel Occlusion Today Differ Significantly From the COSS Population

Stroke ◽  
2021 ◽  
Vol 52 (10) ◽  
Author(s):  
Lars Wessels ◽  
Nils Hecht ◽  
Peter Vajkoczy
Keyword(s):  
Cerebrovascular Disease ◽  
Internal Carotid ◽  
Artery Bypass ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Multivessel Disease ◽  
Vessel Occlusion ◽  
Ischemic Attack

Background and Purpose: Despite the findings reported in the COSS (Carotid Occlusion Surgery Study), patients with atherosclerotic cerebrovascular disease continue to be referred for superficial temporal artery to middle cerebral artery bypass surgery. Here, we determined how today’s patients differ from the population reported in COSS. Methods: We retrospectively analyzed all patients that were referred to our Department for superficial temporal artery to middle cerebral artery bypass surgery of atherosclerotic cerebrovascular disease following the publication of COSS. Results: Between 2012 and 2019, 179 patients were referred for 186 bypass surgeries. Ninety-one (51%) patients suffered atherosclerotic, unilateral internal carotid occlusion and 88 (49%) atherosclerotic multivessel disease. All patients had received intensive medical management. A single transitory ischemic attack or ischemic stroke within the last 120 days according to the inclusion criteria of COSS occurred in only 36 out of 179 (20%) patients, whereas 27 out of 179 (15%) suffered >1 transitory ischemic attack within 120 days, 109 out of 179 (61%) had recurrent minor ischemic stroke, and 7 out of 179 (4%) were hemodynamically unstable and required blood pressure maintenance. The distribution of symptoms did not differ between atherosclerotic unilateral internal carotid artery occlusion and atherosclerotic multivessel disease ( P =0.376) but hemodynamic impairment was significantly greater in atherosclerotic multivessel disease ( P <0.001 for atherosclerotic multivessel disease versus atherosclerotic unilateral internal carotid artery occlusion). The overall perioperative stroke rate was 4.3%. Conclusions: Patients referred for flow augmentation surgery today appear to suffer more severe symptoms and vessel occlusion patterns than patients reported in COSS. A new, carefully designed randomized controlled trial appears warranted, considering the still poor prognosis of severe atherosclerotic cerebrovascular disease.

External Carotid Endarterectomy Followed by Superficial Temporal Artery to Middle Cerebral Artery Anastomosis for Internal Carotid Artery Occlusion with Advanced Ipsilateral External Carotid Stenosis

2008 ◽  
Vol 62 (suppl_5) ◽  
pp. ONS395-ONS399 ◽  
Author(s):  
Takakazu Kawamata ◽  
Yoshikazu Okada ◽  
Akitsugu Kawashima ◽  
Kohji Yamaguchi ◽  
Tomokatsu Hori
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Internal Carotid Artery Occlusion ◽  
External Carotid ◽  
Cerebrovascular Complications

Abstract Objective: For patients with internal carotid artery occlusion with advanced narrowing of the ipsilateral external carotid artery (ECA), we performed preventive carotid endarterectomy (CEA) for the ECA stenosis before superficial temporal artery (STA) to middle cerebral artery (MCA) anastomosis for internal carotid artery occlusion. Methods: Between August 2002 and July 2005, we treated seven patients with such lesions, six men and one woman, ranging in age from 52 to 66 years (median, 60 yr). Before STA-MCA anastomosis, we performed preventive CEA for advanced ECA stenosis (&gt;70%) to ensure sufficient blood flow to the STA. STA-MCA double anastomoses were performed more than 1 month after the CEA. Postoperative cerebrovascular complications and carotid restenosis were investigated. Results: All patients in the present series had an excellent postoperative course without cerebrovascular complications during either the CEA or STA-MCA anastomosis phase. Furthermore, no postoperative carotid restenosis occurred, and all STA-MCA anastomoses were patent during a mean follow-up period of 35.6 months. Conclusion: The present study suggests that surgical management by external CEA followed by STA-MCA anastomosis is safe and effective for patients with internal carotid artery occlusion and advanced stenosis of the ipsilateral ECA.

Sign in / Sign up

Export Citation Format

Share Document