external carotid aneurysm

BACKGROUND: Transcatheter aortic valve implantation (TAVI) has become the standard treatment for severe aortic valve stenosis in patients at increased surgical risk. Percutaneous transfemoral (TF) is the access of choice due to its reduced invasiveness and perioperative morbidity/mortality compared with the trans-axillary, aortic, and apical routes. On the other hand, vascular access complications (VACs) of the TF access are associated with prolonged hospitalization, 30-day, and 1-year mortality...

BACKGROUND: Carotid occlusion often leads to the formation of a collateral network. On rare occasions, due to hemodynamic influence, aneurysms can occur. Here, the authors describe a 69-year-old male presenting with intracerebral hemorrhage secondary to a ruptured aneurysm within such a network. OBSERVATIONS: The patient presented to the emergency department with an altered level of consciousness. Imaging showed a left temporal lobe hemorrhage extending into the ventricle, subdural hematoma, and evidence of contrast extravasation...

BACKGROUND: In the treatment of giant cerebral aneurysms with flow-diverting stents, access to the distal parent artery is critical but occasionally challenging. This article provides our experience with a novel steerable microcatheter in such a situation, as well as a review of the literature. CASE DESCRIPTION: A 73-year-old woman presented with right ptosis and external ophthalmoplegia. Magnetic resonance angiography revealed a giant right cavernous internal carotid artery aneurysm...

The treatment of complex intracranial aneurysms has always been a great challenge in neurosurgery. Craniotomy has a high risk of clipping, there is a risk of rupture at any time, endovascular embolization is relatively low risk, but expensive and easy to relapse, the best treatment needs to be further discussed. Cavernous sinus aneurysms with pituitary adenomas are rare. This case reports a case of complex intracranial aneurysms. Chief complaints are: (1) blepharoptosis with blurred vision for 1 year, (2) headache for 3 days, and (3) digital subtraction angiography showed right internal carotid artery cavernous sinus aneurysm...

Essential sources of arterial vascularisation in the head and neck region are the left and right common carotid arteries (CCA) and their branches. The left CCA (LCCA) originates from the arch of the aorta and the right CCA originates from the brachiocephalic trunk. In this case report, there was a bilateral higher division of CCA at the plane of the greater cornua of the hyoid bone, unilateral tri-ramification of the LCCA and the left external carotid artery (LECA), and the origin of the linguo-facial trunk and the pharyngo-occipital trunk from the LECA...

OBJECTIVE: Optimal management of traumatic extracranial cerebrovascular injuries (ECVI) remains undefined. We sought to evaluate the factors that influence management, and neurologic outcomes (stroke and brain death) following traumatic ECVI. METHOD: A retrospective review of a single level 1 trauma center's prospectively maintained data registry of patients older than 18 years of age with a diagnosis of ECVI was performed from 2013-2019. Injuries limited to the external carotid artery were excluded...

BACKGROUND AND OBJECTIVE: Cerebral revascularization of multiple territories traditionally requires multiple constructs, serial anastomoses, or a combination of direct and indirect approaches. A novel 3-vessel anastomosis technique allows for direct, simultaneous multiterritory cerebral revascularization using a single interposition graft. We herein present our experience with this approach. METHODS: Retrospective review of perioperative data and outcomes for patients undergoing multiterritory cerebral revascularization using a 3-vessel anastomosis from 2019 to 2023...

BACKGROUND: Giant fusiform dolichoectatic vertebrobasilar artery aneurysms are challenging lesions with a poor natural history. When there is progressive brainstem compression from these lesions, endovascular treatment can be insufficient, and bypass surgery remains a possible salvage option. High-flow bypass surgery with proximal occlusion can potentially arrest aneurysm growth, promote aneurysm thrombosis, and reduce rupture risk. The authors describe their experience in two patients with giant fusiform dolichoectatic vertebrobasilar artery aneurysms treated with high-flow bypass...

OBJECTIVE: To confirm the usefulness of the extradural anterior clinoidectomy during the clipping of a lower riding posterior communicating artery (PCoA) aneurysm through cadaver dissection. METHODS: Anatomic measurements of 12 adult cadaveric heads (24 sides total) were performed to compare the microsurgical exposure of the PCoA and internal carotid artery (ICA) before and after clinoidectomy. A standard pterional craniotomy and transsylvian approach were performed in all cadavers...

BACKGROUND: The occipital artery (OA) is a branch of the external carotid artery. It gives rise to several cutaneous, muscular, and meningeal branches to supply different anatomical areas. The implication of OA in the neurosurgical field is well-established in the literature. Our aim in this study is to draw a complete picture of the anatomical variations and neurosurgical applications of the OA. METHODS: A literature review was conducted in Google Scholar and PubMed to review the studies discussing OA, its anatomical variation, and neurosurgical applications...

An 86-year-old man with a history of right internal carotid artery occlusion and two remote left carotid endarterectomies presented with a contained posterior rupture of a carotid pseudoaneurysm. The infectious workup was negative. He underwent transcarotid artery revascularization, including external carotid artery coil embolization and exclusion of the carotid aneurysm with a self-expandable stent graft. He was discharged home on postoperative day 1 with his home antiplatelet and anticoagulant therapy. The 3-month postoperative imaging study demonstrated a widely patent carotid stent without an endoleak...

Giant aneurysms are dangerous lesions requiring endovascular treatment, with high rates of aneurysm recanalization and re-rupture. Reliable in vivo models are rare but are required for testing new endovascular devices. We demonstrate the technical aspects of the creation of giant bifurcation aneurysms in New Zealand white rabbits (2.5-5.5 kg). A 25-30 mm long venous pouch is taken from the external jugular vein, and a bifurcation between both carotid arteries is created microsurgically. The pouch is sutured in the bifurcation to mimic a giant aneurysm...

Minipigs are used as in vivo endovascular models, particularly in stroke and aneurysm research. However, detailed knowledge of the diameters of forelimb arteries that are commonly used as surrogates for human brain-supplying arteries are lacking. This study aimed to determine the diameters of forelimb and neck arteries in Aachen minipigs and to compare those to the diameters of human cerebral brain-supplying arteries in order to assess the validity of the Aachen minipig as a human intracranial in vivo model...

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PURPOSE: To describe a case of a nonbifurcating cervical carotid artery with remnant of the proximal internal carotid artery (ICA). METHODS: A 47-year-old man with unruptured cerebral aneurysm underwent magnetic resonance (MR) angiography of the neck region and intracranial region. The MR machine was a 3-T scanner. Catheter angiography was performed for the treatment of the aneurysm by coil embolization. RESULTS: The proximal main trunk of the left external carotid artery (ECA) was absent, and branches arose separately, indicative of a nonbifurcating cervical carotid artery...

The purpose of this research was to demonstrate the effectiveness and clinical outcome of an external carotid artery-radial artery graft-posterior cerebral artery (ECA-RAG-PCA) bypass in the treatment of complex vertebrobasilar artery aneurysms (VBANs) in a single-center retrospective study. An ECA-RAG-PCA bypass may be a last and very important option in the treatment of complex VBANs when conventional surgical clipping or endovascular interventions fail to achieve the desired outcome. This study retrospectively analyzed the clinical presentation, case characteristics, aneurysm location, size and morphology, choice of surgical strategy, complications, clinical follow-up, and prognosis of the patients enrolled...

Giant cell arteritis (GCA), otherwise known as temporal arteritis, is a form of large vessel vasculitis. Patients may present with a variety of symptoms but the most common include headaches, jaw claudication, fatigue, night sweats and visual disturbance. Diagnosis is made using a combination of temporal artery ultrasound, clinical findings and blood tests and the diagnostic gold standard of a temporal artery biopsy and is sometimes needed for histopathological confirmation. Syphilis is a sexually transmitted disease caused by the spirochaete Treponema pallidum , which can infect the central nervous system and cause neurosyphilis, which can mimic GCA...

BACKGROUND: Rete mirabile of the cerebral artery is a rare anomaly, with most previous cases occurring in the middle cerebral artery or internal carotid artery. Here, we present the first report of unilateral rete mirabile in multiple intracranial arteries with ipsilateral internal carotid artery agenesis. CASE PRESENTATION: A 64-year-old Japanese woman was brought to the emergency department of our hospital in a deep coma. Computed tomography of the head showed severe intraventricular hemorrhage with subarachnoid hemorrhage...

OBJECTIVE: To analyze the immediate and long-term results of simultaneous surgical treatment in patients with upper gastrointestinal cancer and cardiovascular diseases. MATERIAL AND METHODS: There were 9 patients with upper gastrointestinal cancer and cardiovascular diseases who underwent simultaneous surgical treatment. We assessed safety and efficacy of this approach. Mean age of patients was 65.7±5.7 years. Coronary artery disease was diagnosed in 3 patients, aortic valve disease - 1 patient, abdominal aortic aneurysm - 2; 4 patients suffered from isolated mitral valve disease, stenosis of the left vertebral artery, internal and external carotid arteries and Leriche syndrome...

Internal carotid artery (ICA) ligation for placing a high-flow extracranial-intracranial (EC-IC) bypass is used in patients with aneurysms on the cavernous portion of the ICA. Recanalization and rupture after proximal ICA ligation can occur. We present four patients who underwent endovascular distal ICA occlusion and report our surgical technique and treatment results. We ligated the ICA to place an EC-IC bypass using a radial artery (RA) graft. Failure to obtain spontaneous occlusion in the distal region required endovascular treatment an average of 219 days later...