Revascularization of Occluded Internal Carotid Arteries by Hypertrophied Vasa Vasorum: Report of Four Cases

Colón, Gary P.; Deveikis, John P.; Dickinson, Lawrence D.

doi:10.1097/00006123-199909000-00040

Cited by 37 publications

(33 citation statements)

References 15 publications

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“…5,8,9) Eight patients demonstrated carotid string-like angiographical findings associated with ipsilateral carotid artery occlusion, in contrast with the so-called carotid string sign, 6,10) because single or multiple serpiginous channels were seen instead of a single linear or curvilinear contrast string. 9) One patient underwent carotid endarterectomy.…”

Section: Discussionmentioning

confidence: 99%

“…5) However, the judgment basis seemed obscure. CBF examination is necessary for evaluation of the adequacy of the collateral circulation.…”

Section: Discussionmentioning

confidence: 99%

“…Our case presented with several suggestive findings of vasculitis or arteritis similar to Takayasu's disease, whereas most previous cases had an atherosclerotic nature. 5,8,9) The inflammatory process of the large arteries in Takayasu's disease and related arteritis may affect the outer layers of the walls supplied by the vasa vasorum and vasa vasorum may emerge in the media and the intima of the inflamed arteries. 7,12,13) There is some controversy about whether bypass surgery including the subclavian artery is effective against arteritis like Takayasu's disease in terms of long-term outcome of the patient.…”

Section: Discussionmentioning

confidence: 99%

“…12,13) Angiographic evidence has shown that the vasa vasorum can provide collateralization to previously occluded internal carotid arteries. 3,5,8,9,11) All cases were treated conservatively, except one case in which carotid endarterectomy was performed to find that the internal carotid artery was occluded at its origin. 9) We treated a patient with occluded internal carotid artery that was revascularized by the vasa vasorum.…”

Section: Introductionmentioning

confidence: 99%

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Bypass Surgery for Occluded Internal Carotid Artery Revascularized by Vasa Vasorum. Case Report.

Shimizu

Tominaga

Ezura

et al. 2002

Neurol. Med. Chir.(Tokyo)

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A 47-year-old woman presented with two transient ischemic attacks due to occlusion of the left internal carotid artery. The affected artery was revascularized by vasa vasorum. Angiography showed occlusion of the left common carotid artery including the origin of the internal carotid artery. The distal internal carotid artery was revascularized by vasa vasorum at the level of the second cervical vertebral body. Left subclavian artery-internal carotid artery bypass surgery using a saphenous vein graft was performed successfully, during which the narrowed but patent lumen of the internal carotid artery was confirmed. Follow-up angiography showed enlargement of the left internal carotid artery distal to the patent bypass. Reconstructive bypass surgery is a possible treatment for patients with occluded internal carotid artery revascularized by vasa vasorum. Angiographic detection of the lumen of the internal carotid artery is important for surgical consideration.

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Section: Discussionmentioning

confidence: 99%

“…5) However, the judgment basis seemed obscure. CBF examination is necessary for evaluation of the adequacy of the collateral circulation.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Bypass Surgery for Occluded Internal Carotid Artery Revascularized by Vasa Vasorum. Case Report.

Shimizu

Tominaga

Ezura

et al. 2002

Neurol. Med. Chir.(Tokyo)

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“…Atherosclerotic changes cause an increase in the vasa vasorum, which form a dense vascular network within the plaque [3,4], and vessels originating from the arterial lumen may develop and communicate with the vasa vasorum [3,5]. However, after complete occlusion of the internal carotid artery (ICA), recanalisation via the vasa vasorum is rare, with only a few reported cases [5][6][7][8][9][10][11][12].…”

mentioning

confidence: 99%

Recanalisation of the internal carotid artery via the vasa vasorum after coil occlusion

Meguro

Muraoka²,

Terada³

et al. 2011

BJR

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ABSTRACT. Antegrade recanalisation of a completely occluded internal carotid artery (ICA) via the vasa vasorum is extremely rare. Here, we report such a case after proximal endovascular coiling in a case of dissected (i.e. non-atherosclerotic) ICA. A 42-year-old man presented with thromboembolic stroke of the left frontal lobe owing to pseudoocclusion of the left ICA manifesting as motor aphasia and right hemiparesis. There were abundant floating thrombi in the petrous portion of the left ICA. Because of good collateral flow in the left middle cerebral artery territory through the anterior communicating artery and external carotid artery system, endovascular coil embolisation of the left ICA was performed for prevention of further thromboembolic stroke. The patient showed progressive recovery following endovascular treatment, and was discharged with mild right hemiparesis 1 month later. He maintained a regimen of aspirin and physical rehabilitation. At follow-up, 38 months later, the patient was asymptomatic. Angiography demonstrated occlusion of the left ICA and multiple serpiginous vessels originating from the proximal internal and external carotid arteries and which filled the ICA distal to the occlusion. This case suggests that an ICA occluded by proximal coil embolisation-even in a non-atherosclerotic case-might be recanalised via the vasa vasorum. The vasa vasorum supply the arterial blood to the adventitia and outer third of the media in large arteries, whereas diffusion across the endothelial layer supplies oxygen and other nutrients to the endothelium and inner media [1,2]. Atherosclerotic changes cause an increase in the vasa vasorum, which form a dense vascular network within the plaque [3,4], and vessels originating from the arterial lumen may develop and communicate with the vasa vasorum [3,5]. However, after complete occlusion of the internal carotid artery (ICA), recanalisation via the vasa vasorum is rare, with only a few reported cases [5][6][7][8][9][10][11][12].We describe a case of recanalisation of the ICA occluded by endovascular coiling. It seems that collateralisation via the vasa vasorum developed in the 3 year follow-up period. Case reportA 42-year-old man was admitted to the neurology department of a local hospital on 17 August 2005. He had experienced sudden onset of weakness of the right extremities and speech disturbance. CT and MRI of the brain revealed left cerebral infarction, and antiplatelet and anticoagulation therapy (aspirin 100 mg day 21 and argatroban 60 mg day 21 ) was initiated. His neurological symptoms improved satisfactorily but suddenly deteriorated on the third day from onset. Repeat MRI/magnetic resonance angiography (MRA) suggested an increase in cerebral infarction because of the left ICA occlusion, and he was immediately transferred to our department. On admission, his Glasgow coma scale score was 9 (E3V1M5). He had right hemiplegia and motor aphasia. Laboratory data revealed no definitive abnormality. A CT scan showed a low-density area in the left frontal lobe...

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Chronic Occlusion of the Internal Carotid Artery with a Hypertrophied Vas Vasorum, Mimicking High-Grade Stenosis

Khadhraoui

Cimpoca

Gottberg

et al. 2023

The Ischemic Stroke Casebook

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Revascularization of Occluded Internal Carotid Arteries by Hypertrophied Vasa Vasorum: Report of Four Cases

Cited by 37 publications

References 15 publications

Bypass Surgery for Occluded Internal Carotid Artery Revascularized by Vasa Vasorum. Case Report.

Bypass Surgery for Occluded Internal Carotid Artery Revascularized by Vasa Vasorum. Case Report.

Recanalisation of the internal carotid artery via the vasa vasorum after coil occlusion

Chronic Occlusion of the Internal Carotid Artery with a Hypertrophied Vas Vasorum, Mimicking High-Grade Stenosis

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