Cases reported "Carotid Artery Diseases"

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21/271. Simultaneous treatment of a pituitary adenoma and an internal carotid artery aneurysm through a supraorbital keyhole approach.

    We describe a case in which an incidental left carotid aneurysm was found during the preoperative evaluation of a pituitary adenoma. After magnetic resonance imaging (MRI) and angiography delineated their characteristics, we chose to treat both lesions simultaneously through a left supraorbital keyhole approach. The aneurysm clipping was followed by intracapsular resection of the tumor that was identified later as a non-secretory adenoma. The postoperative course was uneventful. This case shows that in carefully selected patients it is possible to treat successfully concurrent conditions through a minimally invasive approach, with the well known advantages of low morbidity and a short hospital stay.
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ranking = 1
keywords = dental
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22/271. Management of carotid 'blowout' with endovascular stent grafts.

    OBJECTIVES/HYPOTHESIS: Since 1992, endovascular techniques for vascular occlusion and stenting have evolved significantly. Endovascular occlusion of the carotid artery has been used in the management of carotid "blowout." Although it seems logical to expand this application to the use of arterial stents to repair rather than occlude the artery when cerebral cross-circulation is inadequate, concerns remain regarding the placement of a foreign body in a contaminated field. The purpose of the present report is to describe our experience with endovascular stents for control of carotid hemorrhage. STUDY DESIGN: Retrospective case review. methods: Retrospective review of three cases of acute or threatened carotid hemorrhage managed with endovascular stent placement. RESULTS: Two patients presented with acute carotid blowout, and one patient with a probable sentinel bleed. All patients previously had been heavily treated with surgery and irradiation: Two had developed pharyngocutaneous fistulas, and one had an open wound filled with tumor that surrounded the carotid artery. All were thought to be at significant risk for stroke if the carotid artery was occluded. In all three patients, stent placement resolved the acute hemorrhage. Mean duration of follow-up was 8.3 months. In two patients, the stent became exposed, ultimately thrombosed or extruded, or both. The third patient had no residual sequelae of stenting but died 3 months later. CONCLUSION: When an unacceptable risk of cardiovascular accident makes occlusion unwise, acute carotid hemorrhage can be successfully managed with directed placement of endovascular stents, but the long-term sequelae of placing these foreign bodies in a field with ongoing contamination make this a temporizing rather than permanent measure for use while more definitive long-term solutions are pursued.
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ranking = 5430.9776813477
keywords = fistula
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23/271. diagnosis and treatment of bilateral traumatic carotid-cavernous sinus fistulae.

    The authors report the diagnosis and successful treatment of a case of traumatic bilateral carotid-cavernous sinus fistula. Direct tamponade of the fistula with a Fogarty catheter and ligation of all cervical carotid vessels was carried out on the left side following ligation on the right side of the common carotid, the internal carotid extra- and intracranially, and of the external carotid artery. The pre-requisite for this procedure was the development of a functional collateral circulation via the posterior communicating arteries from the basilar system. The 18 months follow-up report and the rare reports in the world literature on the operative techniques and the results of treatment of similar cases are discussed.
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ranking = 32585.866088086
keywords = fistula
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24/271. Covered stent-graft repair of the brachiocephalic arteries: technical note.

    OBJECTIVE: The use of a covered stent-graft to repair disruptions of the cervical carotid and vertebral arteries is described. This device maintains vessel patency while effectively excluding pseudoaneurysms, arteriovenous fistulae, and other breaches in the integrity of the arterial wall. methods: Patient 1 bled from a large rent in the proximal common carotid artery as a result of tumor invasion. Patient 2 developed a vertebral arteriovenous fistula after a stab injury to the neck. Patient 3 developed cerebral infarction and an enlarging pseudoaneurysm of the internal carotid artery, also after a stab wound to the neck. RESULTS: All three patients were treated with the Wallgraft endoprosthesis (boston Scientific, Watertown, MA). In each case, the vessel wall defect was repaired while antegrade flow through the artery was preserved or restored. No neurological complications occurred as a result of stent-graft deployment. CONCLUSION: Covered stent-grafts offer an alternative to endovascular occlusion of the parent vessel, thereby expanding the therapeutic options for patients with extracranial cerebrovascular disease. These three cases highlight the usefulness and versatility of these devices for endoluminal reconstruction of the brachiocephalic vasculature.
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ranking = 10861.955362695
keywords = fistula
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25/271. pseudomonas aeruginosa causing a right carotid artery mycotic aneurysm after a dental extraction procedure.

    Mycotic aneurysms of the carotid arteries are rare. We describe a right carotid artery mycotic aneurysm in a 70-year-old man. His symptoms began immediately after a complicated molar extraction and persisted until the diagnosis was made and surgical resection and repair were undertaken. pseudomonas aeruginosa was isolated from multiple blood cultures and excised tissues. We review another 73 cases uncovered by an extensive literature search. bacteremia, recent surgery, head and neck infections, dental infections, and endocarditis are the most common predisposing conditions. Computed tomography and magnetic resonance imaging are techniques for accurately confirming the suspicion of any aneurysm, but angiography is the gold standard. Primary resection of the aneurysm with native vein interposition, in conjunction with prolonged antibiotic therapy, is the preferred strategy. A total of 6 cases thus far, including ours, have been clearly associated with dental surgical procedures. These cases are characterized by rapidly enlarging neck masses in the presence of fever. Microorganisms, particularly gram-negative rods, in contrast to normal oral flora, eg, streptococci and anaerobes, are often isolated. With prompt diagnosis and treatment, outcome is often satisfactory.
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ranking = 6
keywords = dental
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26/271. Calcification of the branches of the external carotid artery detected by panoramic radiography: a case report.

    atherosclerosis, a progressive inflammatory disease, may lead to stroke, coronary artery disease, or peripheral artery disease. The prevalence of atherosclerosis associated with morbidity and mortality is very high in industrialized countries. This report describes the case of a 49-year-old male patient whose panoramic radiograph taken as part of a dental examination showed calcification in the branches of the external carotid artery. The right facial artery and left maxillary, facial, and lingual arteries were also calcified. The patient had a history of thrombosis in the right axillary and brachial veins with extension to half of the brachiocephalic trunk. In addition, selective lesions were found in the aorta and mitral valve. The patient's medical history also included hypertriglyceridemia, essential arterial hypertonia, terminal renal insufficiency, renal anemia, neurogen disturbance micturition, secondary hyperparathyroidism, hyperuricemia, lymphatic edema, polyneuropathy, tachyarrhythmia absoluta, and erysipelas. The case presented reports on the possibility of detecting signs of atherosclerosis in arteries of the maxillofacial region by use of panoramic radiography.
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ranking = 1
keywords = dental
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27/271. Internal carotid artery rotation technique to expose an aneurysm neck: technical note.

    OBJECTIVE: Full exposure of a neck of an aneurysm is important to obliterate it completely. methods: A 51-year-old woman in whom an unruptured aneurysm projecting medially under the optic nerve was incidentally found underwent clipping surgery. The edge of the circumferentially cut distal dural ring was pulled with forceps to rotate the internal carotid artery and to expose the neck of the aneurysm. RESULTS: The neck of the aneurysm was completely obliterated under direct vision. CONCLUSION: This single, neat method exposes the neck of an unruptured paraclinoid aneurysm of the internal carotid artery.
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ranking = 1
keywords = dental
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28/271. Carotidoesophageal fistula complicating carcinoma of the esophagus: report of a case.

    A case of carotidoesophageal fistula complicating carcinoma of the esophagus is reported for the first time in iran. review of the literature up to 1972 revealed four previous reports of this complication and only 92 reported cases of aortoesophageal fistula due to carcinoma of the esophagus.
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ranking = 32585.866088086
keywords = fistula
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29/271. Spontaneous carotid-cavernous fistulas: phlebographic appearance and relation to thrombosis.

    Six consecutive cases with spontaneous carotid-cavernous fistulas were examined with orbital phlebography and bilateral carotid angiography. One of the fistulas was fed only by one internal carotid artery, 1 only by the accessory meningeal branch of the maxillary artery, while 4 were supplied by external as well as internal carotid arteries. The findings at phlebography seem to be characteristic. thrombosis was demonstrated in all 6 cases. Different mechanisms for the genesis of thrombosis in association with carotid-cavernous fistulas are proposed. Alternative therapy methods are discussed.
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ranking = 38016.843769434
keywords = fistula
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30/271. Traumatic pseudoaneurysm and high flow arteriovenous fistula involving internal jugular vein and common carotid artery. Treatment with covered stent and embolization.

    We describe the case of a 36-year-old man who presented following penetrating trauma to the neck. angiography demonstrated a high-flow arteriovenous fistula and large false aneurysm of the common carotid artery that also had contributions from branches of the external carotid artery and the thyrocervical trunk. This was treated with a combination of a covered endovascular stent placed in the common carotid artery and coil embolization of other small feeding vessels.
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ranking = 27154.888406738
keywords = fistula
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