Intracranial stent placement for the treatment of a carotid—cavernous fistula associated with intracranial angioplasty

2003 ◽  
Vol 98 (5) ◽  
pp. 1116-1119 ◽  
Author(s):  
Stanley H. Kim ◽  
Adnan I. Qureshi ◽  
Alan S. Boulos ◽  
Bernard R. Bendok ◽  
Elad I. Levy ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Stent Placement ◽  
Internal Carotid ◽  
High Grade ◽  
Carotid Cavernous Fistula ◽  
Content Type ◽  
Cavernous Fistula ◽  
Fine Print

✓ The authors report a case of an iatrogenic carotid—cavernous fistula (CCF) associated with intracranial angioplasty. Angioplasty was performed using a 3 × 10-mm Open Sail coronary balloon in a patient with high-grade stenosis of the left cavernous internal carotid artery (ICA). After angioplasty, a perforation developed in the cavernous ICA, resulting in a CCF. A 3.5 × 9—mm S670 coronary stent was used to treat the fistula. To the authors' knowledge, this is the first reported case in which a CCF developed after angioplasty was performed using a coronary balloon. Long-term angiographic and clinical evaluation is needed to test the suitability and durability of intracranial angioplasty and stent placement in the treatment of symptomatic intracranial stenosis.

Transarterial closure of persistent carotid-cavernous fistula after carotid ligation

1984 ◽  
Vol 61 (2) ◽  
pp. 402-404
Author(s):  
John P. Kapp ◽  
Joga R. Pattisapu ◽  
J. Larry Parker
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Carotid Bifurcation ◽  
Fogarty Catheter ◽  
Carotid Cavernous Fistula ◽  
Content Type ◽  
Cavernous Fistula ◽  
Cervical Internal Carotid Artery ◽  
Fine Print

✓ A carotid-cavernous fistula which had recurred after trapping, embolization, intracranial packing with muscle, and excision of the cervical carotid bifurcation was successfully closed with a Fogarty catheter introduced through the fibrous remnant of the cervical internal carotid artery.

Giant traumatic false aneurysm of the internal carotid artery associated with a carotid-cavernous fistula

1981 ◽  
Vol 55 (5) ◽  
pp. 813-818 ◽  
Author(s):  
S. V. Ramana Reddy ◽  
Thoralf M. Sundt
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Middle Cerebral Artery ◽  
Internal Carotid ◽  
False Aneurysm ◽  
Carotid Cavernous Fistula ◽  
Content Type ◽  
Cavernous Fistula ◽  
Prolene Suture ◽  
Fine Print

✓ A case of giant traumatic false aneurysm of the intracranial internal carotid artery (ICA) with a concomitant carotid-cavernous fistula is reported. The fistula and the aneurysm persisted after ipsilateral cervical ICA ligation was performed elsewhere. Successful obliteration of the aneurysm and the fistula, with preservation of cross filling of the ipsilateral middle cerebral artery system, was accomplished by ligation of the intracranial ICA proximal to the origin of the posterior communicating artery with a 7–0 prolene suture, followed by transaneurysmal packing of the fistula.

Patient presentation, angiographic features, and treatment of strangulation-induced dissection of the internal carotid artery

2000 ◽  
Vol 92 (3) ◽  
pp. 481-487 ◽  
Author(s):  
Adel M. Malek ◽  
Randall T. Higashida ◽  
Van V. Halbach ◽  
Christopher F. Dowd ◽  
Constantine C. Phatouros ◽  
...  
Keyword(s):  
Domestic Violence ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Stent Placement ◽  
Internal Carotid ◽  
Artery Dissection ◽  
Percutaneous Angioplasty ◽  
Consistent Finding ◽  
Content Type ◽  
Fine Print

✓ Domestic violence leading to strangulation by an abusive spouse can cause carotid artery dissection. This phenomenon is rare and has been described in only three previous instances. The authors present their management strategies in three additional cases.Three young women aged 24 to 43 years were victims of manual strangulation committed by their spouses 3 months to 1 year before presentation. Two of the patients suffered delayed cerebral infarctions before presentation and angiography demonstrated focal, mirror-image severe residual stenoses in the high-cervical internal carotid artery (ICA), which were characteristic of a healed chronic dissection; there was no evidence of fibromuscular dysplasia. One of these patients underwent unilateral percutaneous angioplasty with stent placement, and the other underwent bilateral percutaneous angioplasty. Both patients have recovered from their strokes and remain clinically stable at 8 and 20 months posttreatment, respectively. The third patient presented with bilateral ischemic frontal watershed infarctions resulting from an occluded left ICA and a severely narrowed right ICA. Given the extent of the established infarctions, this case was managed with a long-term regimen of anticoagulation medications, and the patient remains neurologically impaired.These cases illustrate the susceptibility of the manually compressed ICA to traumatic injury as a result of domestic violence. They identify bilateral symmetrical ICA dissection as a consistent finding and the real danger of delayed stroke as a consequence of strangulation. Endovascular therapy in which percutaneous angioplasty and/or stent placement are used can be useful in treating residual focal stenoses to improve cerebral perfusion and to lower the risk of embolic or ischemic stroke.

Incidence and etiology of intracerebral hemorrhage following carotid endarterectomy

1986 ◽  
Vol 64 (1) ◽  
pp. 29-34 ◽  
Author(s):  
Robert A. Solomon ◽  
Christopher M. Loftus ◽  
Donald O. Quest ◽  
James W. Correll
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Intracerebral Hemorrhage ◽  
Cerebral Infarction ◽  
Internal Carotid ◽  
Consecutive Series ◽  
High Grade ◽  
Content Type ◽  
Essentially Normal ◽  
Fine Print

✓ In a consecutive series of 1930 carotid endarterectomies there were eight cases of postoperative intracerebral hemorrhage. One of these patients was operated on 2 weeks following cerebral infarction and had severe uncontrollable hypertension after surgery. A second patient had an intraoperative embolus and bled while fully heparinized on the 3rd postoperative day. Only one patient in the series bled into an area of documented cerebral infarction. The remainder of the cases represented hemorrhage into essentially normal brain. Seven of the eight patients with intracerebral hemorrhage had high-grade internal carotid artery stenosis preoperatively. Although several factors have contributed to the brain hemorrhages in this series of patients, postoperative cerebral hyperperfusion which often follows endarterectomy may have played an important role. Defective cerebrovascular autoregulation in chronically ischemic brain regions may predispose patients to intracerebral hemorrhage after removal of a high-grade stenosis of the internal carotid artery.

Selective opening of the blood—brain barrier by a nitric oxide donor and long-term survival in rats with C6 gliomas

2003 ◽  
Vol 99 (4) ◽  
pp. 728-737 ◽  
Author(s):  
Astrid Weyerbrock ◽  
Stuart Walbridge ◽  
Ryszard M. Pluta ◽  
Joseph E. Saavedra ◽  
Larry K. Keefer ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Carotid Artery ◽  
Brain Tumors ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Term Survival ◽  
Content Type ◽  
Tumor Selective ◽  
Fine Print

Object. The response of brain tumors to systemic chemotherapy is limited by the blood—tumor barrier (BTB). Nitric oxide (NO) has been implicated in the regulation of vascular permeability and blood flow. The authors evaluated the effects of exogenous NO, which was released from a short-acting NO donor (Proli/NO), and those of NO metabolites on the capillary permeability of tumors and normal brain tissue by using quantitative autoradiography in a C6 glioma model in rats. Methods. The Proli/NO was infused at a wide dose range (10−2 to 10−12 M) either intravenously or into the internal carotid artery (ICA) and demonstrated substantial tumor-selective increases in blood-brain barrier (BBB) permeability in response to various-sized tracers ([14C]aminoisobutyric acid, [14C]sucrose, [14C]dextran). Internal carotid artery or intravenous administration of sodium nitrite had a comparable effect on BTB permeability. The NO effect on microvascular permeability could be obtained without causing hemodynamic side effects. The effect of NO on the efficacy of carboplatin chemotherapy was investigated in intracerebral C6 gliomas. Simultaneous intravenous infusions of Proli/NO (10−6 M) and carboplatin (20 mg/kg) led to long-term survival in 40% of rats harboring intracerebral C6 gliomas compared with control animals receiving ICA or intravenous infusions of carboplatin, Proli/NO, or vehicle alone. No residual tumor was demonstrated on histological or magnetic resonance imaging studies performed in rats treated with Proli/NO and carboplatin, and no toxicity was observed. Conclusions. This new approach demonstrated the in vivo efficacy and safety of NO and nitrite in enhancing the delivery of systemically delivered radiolabeled tracers and carboplatin into rat gliomas. The NO-induced tumor-selective BBB disruption and intravenous carboplatin chemotherapy may be more efficacious than current chemotherapy strategies against brain tumors.

Long-term patency of radial artery graft bypass for reconstruction of the internal carotid artery

1999 ◽  
Vol 90 (4) ◽  
pp. 786-790 ◽  
Author(s):  
Kiyohiro Houkin ◽  
Hiroyasu Kamiyama ◽  
Satoshi Kuroda ◽  
Tatsuya Ishikawa ◽  
Akihiro Takahashi ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Radial Artery ◽  
Internal Carotid ◽  
Radial Artery Graft ◽  
Conventional Angiography ◽  
Content Type ◽  
Artery Graft ◽  
Fine Print

✓ Reconstruction of the carotid artery by using a radial artery graft is a useful option that can produce reliable long-term patency for the surgical treatment of giant and/or large aneurysms of the cavernous and paraclinoid internal carotid artery (ICA).During the past 10 years, 43 patients with intracavernous and paraclinoid giant aneurysms of the ICA have been treated by reconstruction of the ICA with radial artery grafts after ligation of the cervical ICA. The long-term patency of the grafted radial artery was evaluated over more than a 5-year period (mean 7.2 years) in 20 of these patients by using magnetic resonance angiography or conventional angiography. There was no late occlusion of the graft in any of these cases. Stenotic graft changes were observed in two cases.

Traumatic carotid-cavernous fistula due to transection of the intracavernous carotid artery

1984 ◽  
Vol 60 (5) ◽  
pp. 1080-1084 ◽  
Author(s):  
Ibrahim A. Sbeih ◽  
Sean A. O'Laoire
Keyword(s):  
Carotid Artery ◽  
Internal Carotid ◽  
High Flow ◽  
Carotid Cavernous Fistula ◽  
Content Type ◽  
Cavernous Fistula ◽  
Complete Transection ◽  
Intracavernous Carotid Artery ◽  
Direct Attack ◽  
Fine Print

✓ The authors report a case of a high-flow posttraumatic carotid-cavernous fistula, with complete steal of the blood flow from the ipsilateral internal carotid artery (ICA). Direct attack on the intracavernous carotid artery was performed using the approach of Parkinson with temporary isolation of the ICA. Complete transection of the artery within the cavernous sinus was encountered. The fistula was occluded by clipping the two ends of the ICA within the sinus. The implications of this previously unreported finding are discussed.

Spontaneous carotid - cavernous fistula produced by ruptured aneurysm of the meningohypophyseal branch of the internal carotid artery

1974 ◽  
Vol 40 (4) ◽  
pp. 539-543 ◽  
Author(s):  
Sixto Obrador ◽  
Juan Gomez-Bueno ◽  
Javier Silvela
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Ruptured Aneurysm ◽  
Selective Angiography ◽  
Carotid Cavernous Fistula ◽  
Content Type ◽  
Cavernous Fistula ◽  
Internal Carotid Arteries

✓ The authors report a case in which the cause of a “spontaneous” carotid-cavernous fistula could not be demonstrated by selective angiography of external and internal carotid arteries. However, postmortem study of the cavernous sinuses revealed an unsuspected ruptured aneurysm of the internal carotid artery at the origin of the meningohypophyseal branch.

Enlarged anterior spinal artery as collateral circulation

1974 ◽  
Vol 41 (3) ◽  
pp. 356-359 ◽  
Author(s):  
Jun Karasawa ◽  
Haruhiko Kikuchi ◽  
Seiji Furuse ◽  
Toshisuke Sakaki ◽  
Yasumasa Makita
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Collateral Circulation ◽  
Internal Carotid ◽  
Vascular Malformations ◽  
Anterior Spinal Artery ◽  
Left Internal Carotid Artery ◽  
Content Type ◽  
Vertebral Arteries ◽  
Fine Print

✓The authors report and discuss two cases in which collateral circulation could be angiographically demonstrated passing through the anterior spinal artery. Case 1 proved to have occlusions of the left internal carotid artery and both vertebral arteries. The basilar artery was visualized via the anterior spinal, the primitive trigeminal, and primitive otic arteries. The presence of multiple vascular malformations and an abnormal anterior spinal artery suggested that the latter had been functioning as collateral circulation since an embryonic stage. In Case 2, both internal carotids and both vertebral arteries were occluded by arteriosclerotic changes. It was assumed that the deleted anterior spinal artery visualized angiographically had developed into a collateral circulation with increasing age.

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