Acute Dissection of the Carotid Artery After Electroconvulsive Therapy

Carotid artery stenting (CAS) is a validated option in the treatment of selected extracranial carotid artery stenosis. Carotid artery dissection during CAS is a rare but potentially devastating complication. We report a case of acute dissection and thrombosis of the left internal carotid artery during filter tip wire engaging maneuvers, complicated by intraoperative complete blindness of the left eye. Immediate conversion to carotid endarterectomy was performed under general anesthesia with electroencephalographic monitoring. The patient was discharged home symptomless and remains asymptomatic eight months after the operation, with normal left internal carotid patency and fully recovered eyesight. In conclusion, the management of acute carotid occlusion during CAS requires emergent evaluation and definitive endovascular or open surgical repair to minimize neurologic morbidity. We advocate that all endovascular procedures are carried out in a well-established surgical environment.

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The formation mechanism of acute dissection of blood blister-like aneurysm and its implication of endovascular treatment

Chinese Neurosurgical Journal ◽

10.1186/s41016-021-00245-1 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Zhongyin Ye ◽

Xianli Lv

Keyword(s):

Carotid Artery ◽

Clinical Outcome ◽

Internal Carotid Artery ◽

Endovascular Treatment ◽

Internal Carotid ◽

Pathologic Change ◽

Open Cell ◽

Clinical Outcome Score ◽

Closed Cell ◽

Acute Dissection

Abstract Background Acute mural dissection of the anterior wall of the internal carotid artery which may contribute to the development of blood blister-like aneurysms (BBLAs) was postulated, and stenting or flow diversion treatment across the soi-disant aneurysm was reported in this study. Methods From December 2016 to December 2018, 8 patients presenting with subarachnoid hemorrhage (SAH) due to BBLA were subjected to endovascular treatment with stent-assisted coiling. Clinical outcomes were evaluated using a clinical outcome score scale. Results Based on angiograms, pathologic change involving the supraclinoid segments of the internal carotid artery (ICA) adjacent to BBLA was found in all patients. This pathologic change meant a focal dissection of the supraclinoid segment of the ICA which constituted the pathogenesis of BBLAs. Closed-cell, open-cell, and braided stents were used in 1, 1, and 6 patients, respectively. Complete obliteration was achieved following endovascular treatment among all 8 patients harboring BBLA. One re-bleeding successive to a closed-cell stent across the aneurysmal neck was observed. Follow-up angiograms revealed stable complete exclusion of all BBLAs from the parent vessel at 3 to 8 months. All patients had a favorable clinical outcome score of 0–1. Conclusions Acute dissection of a focal point of the intracranial vessels underlies the development of BBLAs. Open-cell and braided-cell stent-assisted coiling may constitute appropriate treatment due to good apposition against the vascular walls. Adjunctive coils may facilitate immediate complete occlusion of BBLAs.

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Cerebral retrograde perfusion alternating with carotid artery anterograde perfusion in the surgical treatment of acute dissection of ascending aorta dissection]]>

Brazilian Journal of Cardiovascular Surgery ◽

10.1590/s1678-97412005000200015 ◽

2005 ◽

Vol 20 (2) ◽

Author(s):

Ronaldo D. Fontes ◽

Carlos A. Dias ◽

Am�lcar O. Mocelin ◽

Luiz G. C. Velloso

Keyword(s):

Surgical Treatment ◽

Carotid Artery ◽

Ascending Aorta ◽

Retrograde Perfusion ◽

Acute Dissection

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Performance of Electroconvulsive Therapy in a Patient with Clipping (Yasargil Titanium Clip) of an Aneurysm of the Internal Carotid Artery without Vascular Complications

Brain Stimulation ◽

10.1016/j.brs.2013.01.010 ◽

2013 ◽

Vol 6 (4) ◽

pp. 709-710 ◽

Cited By ~ 1

Author(s):

Maximilian Gahr ◽

Bernhard J. Connemann ◽

Carlos Schönfeldt-Lecuona ◽

Roland W. Freudenmann ◽

Andreas E. Hawlik

Keyword(s):

Carotid Artery ◽

Internal Carotid Artery ◽

Electroconvulsive Therapy ◽

Internal Carotid ◽

Vascular Complications

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Endotoxin Alteration of the Mucopolysaccharide Blood Vessel Coating in Rats

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100050755 ◽

1974 ◽

Vol 32 ◽

pp. 148-149

Author(s):

D. E. Philpott ◽

A. Takahashi

Keyword(s):

Skeletal Muscle ◽

Endothelial Cells ◽

Salivary Gland ◽

Carotid Artery ◽

Basement Membrane ◽

Coronary Vessels ◽

Ruthenium Red ◽

E Coli ◽

Old Rats ◽

The Brain

Two month, eight month and two year old rats were treated with 10 or 20 mg/kg of E. Coli endotoxin I. P. The eight month old rats proved most resistant to the endotoxin. During fixation the aorta, carotid artery, basil arartery of the brain, coronary vessels of the heart, inner surfaces of the heart chambers, heart and skeletal muscle, lung, liver, kidney, spleen, brain, retina, trachae, intestine, salivary gland, adrenal gland and gingiva were treated with ruthenium red or alcian blue to preserve the mucopolysaccharide (MPS) coating. Five, 8 and 24 hrs of endotoxin treatment produced increasingly marked capillary damage, disappearance of the MPS coating, edema, destruction of endothelial cells and damage to the basement membrane in the liver, kidney and lung.

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