The reflux from internal carotid artery to posterior circulation: Variation of anatomy versus pathology

1971 ◽  
Vol 2 (2) ◽  
pp. 65-75 ◽  
Author(s):  
P. B. Wollschlaeger ◽  
G. Wollschlaeger ◽  
V. F. Lopez ◽  
C. L. Mathews ◽  
J. J. Holly ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Posterior Circulation ◽  
Circulation Variation

Flow-related posterior cerebral artery aneurysms with internal carotid artery occlusions: An institutional series

2021 ◽  
pp. 159101992110017
Author(s):  
Waleed Butt ◽  
Luqman Malik ◽  
Permesh Singh Dhillon ◽  
Norman McConachie
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cerebral Artery ◽  
Internal Carotid ◽  
De Novo ◽  
Posterior Cerebral Artery ◽  
Case Series ◽  
Posterior Circulation ◽  
Surveillance Strategy ◽  
Posterior Circulation Aneurysms

Background Aneurysm formation after internal carotid artery (ICA) occlusion has been described in animal models and human case series with alteration of cerebral blood flow dynamics considered an aetiological risk factor. Such de novo aneurysms have seldom been described in the posterior cerebral artery (PCA) with the majority observed in the anterior circulation collateral pathways. Methods We retrospectively reviewed our institutional database of posterior circulation aneurysms in patients with iatrogenic, atherosclerotic or congenital ICA occlusions. A comprehensive review of the online literature using the PubMed and Medline databases was performed to identify previous cases of PCA aneurysms that were considered ‘flow-related’. Results We present five patients with symptomatic or ruptured PCA aneurysms with ICA occlusions. Age at presentation ranged from 21-58 and aneurysm size from 3–12 mm. All cases had angiographic evidence of posterior-anterior flow via the ipsilateral posterior communicating artery (PComA). The clinical presentation, diagnostic imaging and management strategies are further discussed. A literature review identified only two previous reported cases. Conclusion To our knowledge this is the first single centre series of posterior circulation aneurysms in patients with ICA occlusions that are considered to be ‘flow-related.’ The natural history of these rare lesions is unclear and the best management and surveillance strategy requires a patient-tailored approach by an experienced neurovascular team.

“Flow Reversal” and Cure in a Case of Giant Intracranial Aneurysm: A Case Report

2021 ◽  
Author(s):  
Abhidha Shah ◽  
Ravikiran Vutha ◽  
Jash Doshi ◽  
Nishit Trivedi ◽  
Atul Goel
Keyword(s):  
Case Report ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Giant Aneurysm ◽  
External Carotid Artery ◽  
High Flow ◽  
Posterior Circulation ◽  
External Carotid ◽  
Anterior Circulation

AbstractWe describe the case of an 11-year-old girl having a giant anterior circulation aneurysm. The ipsilateral internal carotid artery was entirely blocked and the aneurysm was supplied by posterior circulation. Following a high-flow bypass that connected the external carotid artery to the middle cerebral artery, the giant aneurysm thrombosed spontaneously. We discuss several relatively rare and unique features of the case.

scholarly journals Carotid Endarterectomy in a Patient with Severe Internal Carotid Artery Stenosis with Persistent Trigeminal Artery and Ischemia of the Anterior and Posterior Circulation

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Melanie R. F. Greenway ◽  
Hussam A. Yacoub ◽  
Shweta Varade ◽  
Yevgeniy Isayev
Keyword(s):  
Ischemic Stroke ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Carotid Endarterectomy ◽  
Internal Carotid ◽  
Posterior Circulation ◽  
Left Internal Carotid Artery ◽  
Persistent Trigeminal Artery ◽  
Trigeminal Artery ◽  
Ct Angiogram

Occurrence of cerebral ischemia in the posterior circulation as a result of severe internal carotid artery disease and persistent trigeminal artery is rare. An 81-year-old man with medical history of hypertension and ischemic stroke presented with dizziness, nausea, and mild dysarthria. Magnetic resonance imaging of the brain revealed acute infarcts in the left internal carotid artery territory. CT angiogram revealed a persistent trigeminal artery (PTA) and severe atherosclerosis. The patient developed new neurological symptoms and repeat imaging revealed new acute infarcts in the PTA distribution. After undergoing a left carotid endarterectomy with no complications, the patient was discharged to a skilled nursing facility with no recurrence of ischemic stroke. This case adds a rare complication of an infrequent vascular anomaly to the limited body of the literature.

scholarly journals Canine Model for Selective and Superselective Cerebral Intra-Arterial Therapy Testing

2020 ◽  
Vol 15 (3) ◽  
pp. 107-116
Author(s):  
Kevin M. Camstra ◽  
Visish M. Srinivasan ◽  
Dalis Collins ◽  
Stephen Chen ◽  
Peter Kan ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cerebral Circulation ◽  
Internal Carotid ◽  
Circle Of Willis ◽  
Posterior Circulation ◽  
External Carotid ◽  
Arterial Tree ◽  
Cerebral Disease ◽  
Arterial Access

Purpose: With advancing endovascular technology and increasing interest in minimally invasive intra-arterial therapies such as stem cell and chemotherapy for cerebral disease, the establishment of a translational model with cerebral circulation accessible to microcatheters is needed. We report our experience catheterizing canine cerebral circulation with microcatheters, present high-resolution angiographic images of the canine vascular anatomy, describe arterial branch flow patterns and provide measurements of canine arterial conduits.Materials and Methods: Angiograms were performed on 10 intact purpose-bred hounds. Angiography, measurements of arterial conduits and catheterization information for intracranial arterial branches were obtained.Results: Selective and superselective cerebral angiography was successful in all subjects. Relevant arterial mean diameters include the femoral (4.64 mm), aorta (9.38 mm), external carotid (3.65 mm), internal carotid arteries (1.6 mm), vertebrobasilar system and Circle of Willis branches. Catheterization of the Circle of Willis was achieved via the posterior circulation in all subjects tested (n=3) and the use of flow directed microcatheters resulted in reduced arterial tree deformation and improved superselection of intracranial vessels. Catheterization of the intracranial circulation was attempted but not achieved via the internal carotid artery (n=7) due to its tortuosity and subsequent catheter related vasospasm.Conclusion: The canine cerebral vasculature is posterior circulation dominant. Anterior circulation angiography is achievable via the internal carotid artery, but direct cerebral arterial access is best achieved via the posterior circulation using flow-directed microcatheters. It is feasible to deliver intra-arterial therapies to selective vascular territories within the canine cerebral circulation, thus making it a viable animal model for testing novel intra-arterial cerebral treatments.

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