1/3. Bypass surgery for occluded internal carotid artery revascularized by vasa vasorum--case report.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.- - - - - - - - - - ranking = 1keywords = vasorum (Clic here for more details about this article) |
2/3. Carotid pseudostring sign from vasa vasorum collaterals.OBJECTIVE: To describe the spectral and color Doppler imaging findings in 2 cases of internal carotid artery occlusion with vasa vasorum collateral flow, which we term the "pseudostring sign." methods: Spectral and color Doppler imaging findings in both cases were reviewed. magnetic resonance angiography in 2 cases and conventional angiography in 1 case were also reviewed. RESULTS: Both patients had color Doppler images showing that the internal carotid artery was a narrow, stringlike vessel with arterial flow that had normal spectral Doppler features (velocity < 125 cm/s with a normal waveform). magnetic resonance angiography in 1 patient showed total occlusion of the proximal internal carotid artery with patent vasa vasorum collaterals reconstituting the lumen distally. In the second patient, magnetic resonance angiography showed total occlusion of the proximal internal carotid artery, and conventional angiography showed proximal occlusion with collateral flow through the vasa vasorum. CONCLUSION: Proximal internal carotid artery occlusion with vasa vasorum collateral flow should be considered when color Doppler imaging shows a seemingly narrow internal carotid artery with tortuosity and normal spectral Doppler features. patients with these features should not undergo carotid endarterectomy directly on the basis of only the Doppler findings.- - - - - - - - - - ranking = 1.1428571428571keywords = vasorum (Clic here for more details about this article) |
3/3. Collateralization of an occluded internal carotid artery via a vas vasorum.BACKGROUND: Reopening of an occluded internal carotid artery (ICA) is often seen in dissections but only rarely occurs in atherothrombotic occlusion of the internal carotid artery. CASE DESCRIPTION: A 60-year-old man suffered a minor stroke with dysphasia in March 1995. color-coded duplex ultrasonography of his neck arteries revealed a left ICA occlusion. He was placed on a regimen of aspirin and followed up clinically and with ultrasonography. At follow-up 18 months later, the patient was asymptomatic. On duplex ultrasonography his left occluded ICA was found to be reopened, with a residual, proximal, high-grade stenosis. However, intra-arterial digital subtraction angiography demonstrated a persistent ICA occlusion and a vas vasorum originating from the carotid bulb and draining into the ICA distal to the occlusion. CONCLUSIONS: The rare collateralization of an occluded ICA by vasa vasorum seems to take several months. It can be a pitfall in the ultrasound diagnosis of carotid artery occlusive disease.- - - - - - - - - - ranking = 0.85714285714286keywords = vasorum (Clic here for more details about this article) |