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Carotid artery dissection

Mayuko Motomura, Koichi Watanabe, Yoko Tabira, Joe Iwanaga, Wakako Matsuuchi, Daichi Yoshida, Tsuyoshi Saga, Koh-Ichi Yamaki
We encountered a case of duplicated right vertebral artery during an anatomical dissection course for medical students in 2015. Two vertebral arteries were found in the right neck of a 91-year-old female cadaver. The proximal leg of the arteries arose from the area between the right subclavian artery and the right common carotid artery that diverged from the brachiocephalic artery. The distal leg arose from the right subclavian artery as expected. The proximal leg entered the transverse foramen of the fourth cervical vertebra and the distal leg entered the transverse foramen of the sixth cervical vertebra...
March 16, 2018: Kurume Medical Journal
Keiji Uchida, Norihisa Karube, Keiichiro Kasama, Tomokazu Minami, Shota Yasuda, Motohiko Goda, Shinichi Suzuki, Kiyotaka Imoto, Munetaka Masuda
OBJECTIVE: The control of malperfusion is the key to improving the outcomes of surgery for type A acute aortic dissection. We revised our treatment strategy to reperfuse each ischemic organ before central repair. METHODS: Our current early reperfusion strategy consists of percutaneous coronary artery intervention for coronary malperfusion, direct surgical fenestration for carotid artery occlusion, active perfusion of the superior mesenteric artery for visceral malperfusion, and external shunting from the brachial artery to the femoral artery for lower limb ischemia...
February 13, 2018: Journal of Thoracic and Cardiovascular Surgery
Nupoor Narula, Daniella Kadian-Dodov, Jeffrey W Olin
Fibromuscular dyplasia (FMD) is an under-recognized non-atherosclerotic, non-inflammatory arteriopathy that occurs most commonly in middle-aged women, but may affect individuals of all age groups. FMD may result in stenosis, aneurysm, dissection, occlusion, or arterial tortuosity. Recently published data demonstrated a genetic association of FMD with a variant in the phosphatase and actin regulator 1 gene (PHACTR1), substantiating that the pathogenesis of this condition has genetic contribution. The renal and extracranial carotid and vertebral arteries are most often involved, although any arterial bed may be affected...
March 10, 2018: Progress in Cardiovascular Diseases
Naureen Narula, Faraz Siddiqui, Nakul Katyal, Akshay Avula, Michel Chalhoub
Internal carotid artery dissection (ICAD) accounts for 25% of cerebrovascular accidents in young and middle-aged patients. Dissection occurs when the intimal wall of an artery is damaged as a result of trauma or defect. ICAD development after dental work is a relatively uncommon phenomenon. Our study highlights a rare presentation of ICAD that resulted from a direct lidocaine nerve block injection in a patient undergoing pulpotomy for a right maxillary second premolar tooth. We have described the case and reviewed the literature on this rare but potentially life-threatening phenomenon...
January 5, 2018: Curēus
Themistoklis I Papasilekas, Konstantinos M Themistoklis, Alexandros A Andreou
Blister aneurysms are rare lesions characterized by a bleb-like appearance in combination with prominent fragility. They mainly affect the supraclinoid internal carotid artery and they are often thought of as dissecting or even false lesions. Treatment of such lesions has been a matter of debate during the past few years with authors competing, in an ever changing field, for best results. Both surgical and endovascular modalities have been tried, with every technique having though its own limitations and pitfalls...
March 7, 2018: Clinical Neurology and Neurosurgery
Mikiya Beppu, Yohei Mineharu, Hirotoshi Imamura, Hidemitsu Adachi, Chiaki Sakai, Shoichi Tani, Koichi Arimura, So Tokunaga, Nobuyuki Sakai
BACKGROUND AND PURPOSE: Although in-stent protrusion is a potential risk factor of thromboembolism following carotid artery stenting, the correlation between in-stent protrusion and postoperative ipsilateral stroke has not been well examined. MATERIALS AND METHODS: We retrospectively reviewed 342 consecutive carotid artery lesions in 319 patients who underwent carotid artery stenting between April 2008 and April 2015. After excluding cases with carotid artery dissection and acute occlusion, 301 lesions in total of 277 patients were included in the analysis...
March 7, 2018: Journal of Neuroradiology. Journal de Neuroradiologie
Hong Jin, Daniel Y Li, Ekaterina Chernogubova, Changyan Sun, Albert Busch, Suzanne M Eken, Peter Saliba-Gustafsson, Hanna Winter, Greg Winski, Uwe Raaz, Isabel N Schellinger, Nancy Simon, Renate Hegenloh, Ljubica Perisic Matic, Maja Jagodic, Ewa Ehrenborg, Jaroslav Pelisek, Hans-Henning Eckstein, Ulf Hedin, Alexandra Backlund, Lars Maegdefessel
miRNAs are potential regulators of carotid artery stenosis and concordant vulnerable atherosclerotic plaques. Hence, we analyzed miRNA expression in laser captured micro-dissected fibrous caps of either ruptured or stable plaques (n = 10 each), discovering that miR-21 was significantly downregulated in unstable lesions. To functionally evaluate miR-21 in plaque vulnerability, miR-21 and miR-21/apolipoprotein-E double-deficient mice (Apoe-/- miR-21-/- ) were assessed. miR-21-/- mice lacked sufficient smooth muscle cell proliferation in response to carotid ligation injury...
January 31, 2018: Molecular Therapy: the Journal of the American Society of Gene Therapy
Charles Timothy West, Cecilia Brassett, Michael Gaunt
BACKGROUND: The carotid sinus (CS) is a dilatation in the carotid bifurcation usually at the origin of proximal internal carotid artery (ICA). It contains baroreceptors which influence blood pressure. Variations in the location of the CS are of importance as atheromatous plaque commonly forms in this area and procedures such as carotid endarterectomy are performed to reduce the risk of stroke. Inadvertent stimulation of the CS baroreceptors during interventions can have profound effects on the patient's hemodynamic status both intra- and postoperatively, causing serious complications...
March 3, 2018: Folia Morphologica (Warsz)
Jong Young Lee, Jong-Hwa Park, Hong Jun Jeon, Dae Young Yoon, Seoung Woo Park, Byung Moon Cho
PURPOSE: A complicated course of the femoral route for neurointervention can prevent approaching the target. Thus, we determined whether transcervical access in the hybrid angiosuite is applicable and beneficial in real practice. METHODS: From January 2014 to March 2017, this approach was used in 17 of 453 (3.75%) cases: 11 cerebral aneurysms (4 ruptured, 7 unruptured), 4 acute occlusions of the large cerebral artery, 1 proximal internal carotid artery (ICA) stenosis, and 1 direct carotid cavernous fistula (CCF)...
March 1, 2018: Neuroradiology
Stavros K Kakkos, Peter Zampakis, George C Lampropoulos, Leonidas Paridis, Charalampos Kaplanis, Dimitra Bantouna, Konstantinos M Nikolakopoulos, Chrysanthi P Papageorgopoulou, Christina Kalogeropoulou, Ioannis A Tsolakis
A 41-year-old woman presented with a large painful and tender mass of the left side of her neck located just below the angle of the mandible. She was also complaining of frequent attacks of symptoms ranging from dizziness upon resuming the erect position to frank syncope. Color-coded duplex showed a large well-vascularized vascular mass at the level of the carotid bifurcation, suggesting the diagnosis of a carotid body tumor (CBT). A computerized tomographic angiography confirmed the diagnosis of a CBT, which measured 5...
January 1, 2018: Vascular and Endovascular Surgery
Paul Cohen, Nicholas Musisca, William Binder
[Full article available at].
March 1, 2018: Rhode Island Medical Journal
Akira Baba, Hideomi Yamauchi, Nobuhiro Ogino, Yumi Okuyama, Shinji Yamazoe, Yohei Munetomo, Yuko Kobashi, Takuji Mogami, Hiroya Ojiri
Positional change in the retropharyngeal carotid artery, a rare phenomenon over time, is even rarer in previous reports, and it is important to be aware of this before any neck surgical procedure. A woman in her 50s underwent an anterior maxillectomy for upper gingival cancer, without neck dissection. The patient had medical histories of diabetes mellitus and liver dysfunction, with unremarkable family histories. Serial neck contrast-enhanced computed tomography for detecting locoregional recurrence had been performed as a follow-up during 4 years...
December 2017: Radiology Case Reports
Robert D Safian
Optical coherence tomography (OCT) is rarely necessary to guide clinical decisions about the appropriateness of carotid revascularization. For carotid artery stenting (CAS), computed tomography angiography is the best imaging tool to assess arch, carotid, and lesion-specific anatomy, including vessel dimensions and calcification. OCT is a coherent strategy after CAS to assess ambiguous angiographic findings and to guide appropriate therapy for dissection, thrombosis, and plaque prolapse.
February 15, 2018: Catheterization and Cardiovascular Interventions
Josep M Casadesús, Fernando Aguirre, Ana Carrera, Pere Boadas-Vaello, Maria T Serrando, Francisco Reina
The purpose of this study was to suggest modifications of autopsy techniques in order to improve post-mortem diagnosis of arterial gas embolism (AGE) based on multidisciplinary investigation of SCUBA diving fatalities. Five adult human cadavers from the voluntary donation program of the Human Anatomy Laboratory, and eight judicial autopsied bodies of SCUBA divers from the Forensic Pathology Service were assessed. Before performing any autopsies, we accessed the diving plan and the divers' profiles for each case...
February 19, 2018: Forensic Science, Medicine, and Pathology
Monalisa Ribeiro Silva, Alyne Oliveira Correia, Gabriel Cabral Alencar Dos Santos, Lucas Leimig Telles Parente, Keicy Parente de Siqueira, Danielly Gonçalves Sombra Lima, Jonathan Almeida Moura, Ana Elisa da Silva Ribeiro, Roberta Oliveira Costa, Daniel Luna Lucetti, Elaine Cristina Pereira Lucetti, Kelly Rose Tavares Neves, Glauce Socorro de Barros Viana
Valproic acid (VA) is an antiepileptic that is also used for the treatment of bipolar disorders. The objective was to evaluate the neuroprotective effects of VA on a brain ischemia model. The groups of male Wistar rats were: SO (sham-operated), ischemic and ischemic treated with VA (25, 50 and 100 mg/kg, p.o.). After anesthesia with ketamine and xilazine, the animals were subjected to clamping of carotid arteries (30 min) and reperfusion. Except for the carotid clamping, the SO group was submitted to the same procedure...
February 13, 2018: Pharmacology, Biochemistry, and Behavior
Alfredo Fede, Andrea Pacchioni, Carlo Penzo, Riccardo Turri, Giuseppe Marchese, Daniela Benedetto, Salvatore Saccà
Internal carotid artery dissection is one of the possible causes of stroke in young adults. The effectiveness of medical therapy alone is often limited and endovascular strategy should be considered, particularly in the presence of persisting neurological symptoms. Currently, there is no general consensus on the most appropriate therapeutic strategy to follow in symptomatic carotid artery dissection. We here report a case of symptomatic carotid artery dissection treated with an endovascular approach, and we review the recent literature regarding this therapeutic strategy...
January 2018: Giornale Italiano di Cardiologia
Ernesto L Schiffrin
Gupta et al. [Cell 2017; 170: 522-533] have shown that a genetic variant associated with the 5 vascular diseases is a distal regulator of endothelin (ET)-1 gene (EDN1) expression. A common single nucleotide polymorphism (SNP) in the third intron of the PHACTR1 gene, rs9349379, is the potential variant responsible for increased risk of coronary artery disease, and lower risk of migraine, carotid dissection, fibromuscular dysplasia, and hypertension. Since ET-1 acts through ET type B receptors (ETBR) on endothelial cells to stimulate the production of nitric oxide and prostacyclin and induce vasodilation, this may contribute to these findings...
February 15, 2018: Nephron
Philipp Erhart, Tobias Brandt, Beate K Straub, Ingrid Hausser, Sabine Hentze, Dittmar Böckler, Caspar Grond-Ginsbach
BACKGROUND AND PURPOSE: A recurrent duplication of chromosome 16p13.1 was associated with aortic dissection as well as with cervical artery dissection. We explore the segregation of this duplication in a family with familial aortic disease. METHODS: Whole exome sequencing (WES) analysis was performed in a patient with a family history of aortic diseases and ischemic stroke due to an aortic dissection extending into both carotid arteries. RESULTS: The index patient, his affected father, and an affected sister of his father carried a large duplication of region 16p13...
February 14, 2018: Molecular Genetics & Genomic Medicine
Lin Qiao, Jianhua Fu, Xindong Xue, Yongyan Shi, Li Yao, Wanjie Huang, Jun Li, Dan Zhang, Na Liu, Xin Tong, Yanna Du, Yuqing Pan
As research into periventricular leukomalacia (PVL) gradually increases, concerns are emerging about long‑term neuron injury. The present study aimed to investigate neuronal injury and the relevant alterations in apoptosis and autophagy in a PVL model established previously. A rat model of hypoxia‑ischemia‑induced PVL was established. In the model group, Sprague‑Dawley (SD) rats [postnatal day 3 (P3)] were subjected to right common carotid artery ligation followed by suturing and exposed to 6‑8% oxygen for 2 h; in the control group, SD rats (P3) were subjected to right common carotid artery dissection followed by suturing, without ligation and hypoxic exposure...
February 7, 2018: Molecular Medicine Reports
Karanarak Urasyanandana, Dittapong Songsang, Taweesak Aurboonyawat, Ekawut Chankaew, Pattarawit Withayasuk, Anchalee Churojana
Methods Patients with cerebral artery dissections were reviewed in a hospital setting from 2008 to 2015. Clinical presentations, lesion locations, treatment modalities, functional outcomes, and mortality were reviewed. Parent artery occlusion was the first choice for surgery or endovascular treatment of a hemorrhagic dissecting cerebral artery. Endovascular or surgical reconstructive treatment was indicated in patients whose parent artery could not be occluded. Favorable functional outcomes were determined using modified Rankin Scale (mRS) scores of 0-2...
January 1, 2018: Interventional Neuroradiology
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