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paraphrasedoutput:BACKGROUND The bonnet bypass was originally intended for common carotid artery occlusion. However, the traditional first-generation low-flow superficial temporal artery bypass, the M4 middle cerebral artery bypass, can be enhanced by a side-to-side bypass using an intraluminal suture technique to increase perfusion by antegrade and retrograde flow. OBSERVATIONS In the case of a patient with symptomatic common carotid occlusion, the STA-M4 bypass was reimagined by the authors in a case where the ipsilateral STA filled in a reverse manner from the contralateral external carotid branches over the scalp vertex in a randomized manner.
Source link: https://doi.org/10.3171/case2177
BACKGROUND Large pituitary adenomas can rarely result in pressure of the cavernous internal carotid artery as a result of chronic tumor compression or invasion. The authors explore a case of pituitary apoplexy resulting in acute bilateral ICA occlusion with resultant stroke. A significant perfusion delay in the anterior circulation was discovered by CT perfusion, which caused a significant perfusion delay. paraphrased compression limits Pituitary apoplexy may be present as an acute stroke due to flow-limiting carotid compression. LESSONS Pituitary apoplexy can be a rare occurrence of acute stroke and should be treated with immediate surgical decompression rather than attempted angioplasty in order to restore blood flow and prevent cerebral ischemia.
Source link: https://doi.org/10.3171/case21370
Mechanical thrombolysis and intravenous thrombolysis are the gold standard of care for large vessel occlusion strokes. With a National Institutes of Health Stroke Scale of 5 points, 10–20% of LVO patients report as "minor strokes" or "minor strokes. " Following clinical deterioration after more than 48 hours, we present the case of a 71-year-old Caucasian male “minor stroke” patient with LVO, good collateral flow through the ophthalmic artery, and a rescued MT following rescue MT following clinical deterioration. For a follow-up and modified therapy in the cerebral infarction score for angiographic results, NIHSS and modified Rankin scale were used. When a clinical deficit outstinfarct demarcation, late intervention MTs can be encouraged.
Source link: https://doi.org/10.1155/2022/9036082
The authors explore the case of a patient with a symptomatic giant aneurysm of the posterior communicating artery that is associated with bilateral idiopathic occlusion of the internal carotid artery. 3 balloon occlusion test of the left VA; 2 vertebro-vertebral bypass with saphenous vein graft to ensure blood flow in the event that embolization resulted in the PCoA's closing; and 4 GDC embolization of the aneurysm by the posterior circulation graft to ensure complete removal of the lesion from arterial circulation and preservation of the PCoA. The patient did not have any neurological abnormalities during three months of follow-up study; at a 1-year control examination, magnetic resonance MR imaging, and MR angiography, all confirmed complete exclusion of the aneurysm and patency of the two bypasses.
Source link: https://doi.org/10.3171/jns.2002.96.1.0135
The authors describe a case of urgent carotid artery stent placement for a symptomatic acute CA occlusion following carotid endarterectomy. During the CA bifurcation, Cerebral angiography revealed the exclusion of the right common CA at the CA bifurcation. The proximal cervical ICA is overlapping in two coronary stents placed in tandem in the right CCA and internal CA, overlapping at the proximal cervical ICA. Diagnostic angiography can reveal vital data about CA and intracranial circulation that will help in the diagnosis of postoperative stroke after CEA. Following CEA, stent placement may be considered as an alternative therapy for acute CA occlusion or dissection.
Source link: https://doi.org/10.3171/jns.2004.101.1.0151
Object Preliminary experience with the C-Port Flex-A Anastomosis System has been used to enable fast automated anastomosis in coronary artery bypass surgery. Methods Four patients with symptomatic carotid artery occlusion were selected for C-Port-based EC-IC bypass surgery if they met the following criteria: 1 transient or moderate persistent signs of focal ischemia; 3 hemodynamic instability; and 4 had informed consent. Bypasses were performed using a radial artery graft that was proximally anastomosed to the superficial temporal artery trunk, the cervical external, or common CA. In one case, the donor artery and the radial artery graft were transient asymptomatic extracranial spasm of the donor artery and the radial artery graft. During the follow-up course, two patients developed a narrow zone of infarction on CT scanning. C-Port Flex-A-Assisted high-flow EC-IC bypass surgery is a technically feasible option in patients with symptomatic CA occlusion, and is a clinically acceptable procedure.
Source link: https://doi.org/10.3171/2009.2.jns081388
The onset of the supra-aortic vessels' symptoms exacerbate occlusive lesions at the source of the supra-aortic vessels, which pose a challenge for treatment. Endovascular angioplasty and stent placement via the transfemoral method is possible, but finding a stable position for the guide catheter via this strategy is technically difficult. The authors explore the case of a 56-year-old man who presented with symptomatic occlusion of a previously placed stent at the base of the left common carotid artery. An endovascular revascularization of the left CCA was planned. However, the lack of a lumen proximal to the stent prevented stable placement of a guide catheter via the transfemoral route. To maintain fluid flow from the external to the internal carotid artery and avoid embolism into the ICA, the left CCA was surgically distal to the occlusion and clamped just proximal to its bifurcation. The patient remained neurologically stable, and postoperative findings showed improvement in cerebral perfusion.
Source link: https://doi.org/10.3171/2008.9.jns08774
The purpose of this research was to determine the presence of angiographically identifiable skull base arterial branches that could possibly act as collateral conduits during a balloon occlusion test of the internal carotid artery. When permanent ICA occlusion was achieved more correctly, the authors proposed that neurological deficiencies in patients who had previously tolerated the occlusion test may be attributed to unrecognized collateral support through these channels. More than half of the patients had angiographically identifiable and possibly hemodynamically significant skull base branches of the ICA, and around one quarter had more than one identifiable branch. Patients should be screened during angiography tests done before BOT in branches of the proximal intracranial ICA, and that the BOT's branch should be relocated distally if such branches are identified, according to the authors.
Source link: https://doi.org/10.3171/jns.2005.102.1.0045
BHIs ipsilateral to the site of ICA occlusion, constitutive ICA stenosis, prevalence of contralateral ICA stenosis, contralateral BHI, number of collateral pathways, and presence of hypertension, diabetes, smoking, and hyperlipidemia were all found in a multiple stepwise linear regression analysis, which included the following variables: patient age, percentage of contralateral ICA stenosis, intralateral BHI, BHI Regardless of the presence of an anterior collateral pathway, the study revealed that collateral pathways and the presence of the anterior communicating artery alone were correlated with lower BHI values than those found in the presence of two or three collateral vessels alone. Patients with occlusive disease of the CA have personal anatomical and functional characteristics, and it can be concluded that the cerebral hemodynamic status of patients with occlusive disease of the CA is affected by personal anatomical and functional characteristics.
Source link: https://doi.org/10.3171/jns.2001.94.4.0559
The authors undertook emergent surgical embolectomy of left middle cerebral artery occlusion, and the patient recovered quickly without focal deficit and regained premorbidity. MCA occlusion due to carotid plaque rupture and CEA may be a safer and more effective alternative to endovascular therapy from the standpoint of minimizing the possibility of secondary embolism that may otherwise occur as a result of the manipulation of devices within a thin region of plaque.
Source link: https://doi.org/10.3171/2014.4.jns132441
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