Left common carotid artery to left innominate vein arteriovenous fistula after transvenous laser lead extraction

2022 ◽  
Author(s):  
Patrick Levesque ◽  
Benoît Plourde ◽  
Frédéric Jacques ◽  
Éric Charbonneau ◽  
Marie‐Ève Audet ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Arteriovenous Fistula ◽  
Common Carotid Artery ◽  
Left Common Carotid Artery ◽  
Innominate Vein ◽  
Lead Extraction ◽  
Left Innominate Vein ◽  
Laser Lead Extraction

Multimodality Treatment of a Complex Cervicocerebral Arteriovenous Shunt in a Patient With CHARGE Syndrome

Neurosurgery ◽  
2010 ◽  
Vol 67 (1) ◽  
pp. E208-E209 ◽  
Author(s):  
Shervin R. Dashti ◽  
Robert F. Spetzler ◽  
Min S. Park ◽  
Michael F. Stiefel ◽  
Humain Baharvahdat ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Vertebral Artery ◽  
Common Carotid Artery ◽  
Heart Defects ◽  
Charge Syndrome ◽  
Left Common Carotid Artery ◽  
Innominate Vein ◽  
Arteriovenous Shunt ◽  
Left Vertebral Artery ◽  
External Carotid

Abstract OBJECTIVE We present our management of a unique case of complex arteriovenous shunt with vascular steal in the left-sided head and neck vessels in a child with CHARGE (Coloboma of the eye, Heart defects, Atresia of the choanae, Retardation of growth and/or development, Genital and/or urinary abnormalities, and Ear abnormalities and deafness) syndrome. CLINICAL PRESENTATION A 10-year-old girl presented with high-output heart failure. Cerebral angiography revealed high-flow abnormal fistulous connections between the left common carotid artery and innominate vein as well as between the vertebral artery and innominate vein. There was significant collateral blood flow to the fistulae from the left external carotid artery and left thyrocervical and costocervical trunks. INTERVENTION The left vertebral artery-to-innominate vein fistula was occluded by endovascular means during temporary balloon occlusion. The left common carotid artery-to-innominate vein fistula was occluded through neck dissection with surgical clipping. CONCLUSION Combined neurosurgical and endovascular techniques were used successfully to manage a complex arteriovenous fistula in a patient with CHARGE syndrome. Challenges in therapeutic decision making are discussed.

scholarly journals Synchronous Carotid Bifurcation Endarterectomy and Retrograde Kissing Stenting of the Innominate and Left Common Carotid Artery in a Patient with a Bovine Aortic Arch

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Alessandro Robaldo ◽  
Guido Carignano ◽  
Alberto Balderi ◽  
Claudio Novali
Keyword(s):  
Carotid Artery ◽  
Aortic Arch ◽  
Common Carotid Artery ◽  
Carotid Arteries ◽  
High Risk Patient ◽  
Carotid Bifurcation ◽  
Left Common Carotid Artery ◽  
The Right ◽  
Bovine Aortic Arch ◽  
Common Carotid Arteries

Management of the symptomatic multiple stenosis of supra-aortic vessels (MSSVs) in a “bovine” aortic arch (BAA) configuration is infrequently reported. The optimal treatment choice remains debatable. A successful hybrid treatment for a proximal critical stenosis of the innominate and left common carotid artery was performed in a high-risk patient with a tandem symptomatic lesion in the right carotid bifurcation and a concentric vulnerable plaque in the bovine trunk. This case supports the feasibility, safety, and efficacy of a combined carotid bifurcation endarterectomy and retrograde kissing stenting of common carotid arteries with cerebral protection after evaluation of radiological, anatomical, and clinical parameters.

scholarly journals Breaking the Rules: Left Common Carotid Artery from the Main Pulmonary Artery in an Infant with a Vascular Ring

CASE ◽  
2021 ◽  
Author(s):  
Stephan Juergensen ◽  
Emilio Quezada ◽  
Norman H. Silverman ◽  
Jeffrey G. Gossett ◽  
Peter Kouretas ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Pulmonary Artery ◽  
Common Carotid Artery ◽  
Vascular Ring ◽  
Main Pulmonary Artery ◽  
Left Common Carotid Artery

Electrophysiological-anatomic correlates of ATP-triggered vagal reflex in the dog. III. Role of cardiac afferents

1996 ◽  
Vol 270 (5) ◽  
pp. H1785-H1790 ◽  
Author(s):  
G. Katchanov ◽  
J. Xu ◽  
C. M. Hurt ◽  
A. Pelleg
Keyword(s):  
Carotid Artery ◽  
Common Carotid Artery ◽  
Left Common Carotid Artery ◽  
Descending Aorta ◽  
Chronotropic Action ◽  
Vagal Reflex ◽  
Vagal Afferent ◽  
The Asymmetry ◽  
Cardiac Afferents ◽  
Afferent Terminals

To test the hypothesis that the asymmetry in the afferent traffic of the intra-right atrium (RA) ATP-triggered vagal reflex is due to the stimulation by ATP of extrapulmonary (i.e., cardiac) vagal chemosensitive afferent terminals, ATP, adenosine, and capsaicin were given into the canine RA and the aortic root (AR; n = 12); ATP and adenosine were also administered into the left common carotid artery and the descending aorta (n = 6). The negative chronotropic action [i.e., suppression of sinus node (SN) automaticity] of the test compounds and time to peak effect (tp) were determined. Under baseline conditions, ATP given into the left common carotid artery had a relatively very small effect. ATP given into the descending aorta had no effect. In contrast, intra-RA and intra-AR ATP markedly suppressed SN automaticity, the former less than the latter; the opposite was true for capsaicin. Intra-RA adenosine was much less potent than intra-RA ATP. The tp of intra-RA ATP and intra-RA adenosine were larger than the tp of intra-AR ATP. Pulmonary denervation did not alter the effects of intra-RAATP, intra-ARATP, or intra-AR capsaicin but almost abolished the effect of intra-RA capsaicin. Subsequent bilateral, but not left, cervical vagotomy markedly reduce the effects of ATP and eliminated the difference between the effects of ATP and adenosine. In addition, tp of intra-RA ATP and intra-AR ATP increased substantially and were similar to tp of adenosine. It was concluded that 1) ATP can stimulate vagal afferent terminals not only in the lungs but also in the heart, 2) the latter constitutes the vagal component of the negative chronotropic action of intra-RA or intra-AR ATP on SN automatically, and 3) the asymmetry in the vagal afferent traffic elicited by ATP in the heart (i.e., right vagal dominance) supersedes the symmetrical vagal afferent traffic triggered by intrapulmonary ATP.

scholarly journals Diagnostic dilemmas of multislice CT angiography in the evaluation of the degree of common carotid artery stenosis

2010 ◽  
Vol 138 (7-8) ◽  
pp. 494-497
Author(s):  
Dragoslav Nenezic ◽  
Slobodan Tanaskovic ◽  
Predrag Gajin ◽  
Nenad Ilijevski ◽  
Goran Vucurevic
Keyword(s):  
Carotid Artery ◽  
Ct Angiography ◽  
Common Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Soft Tissues ◽  
Multislice Ct ◽  
Diagnostic Procedures ◽  
Left Common Carotid Artery ◽  
Artery Stenosis ◽  
High Grade

Introduction. Multislice CT angiography (CTA) is a noninvasive and quick technique to image carotid artery stenosis, as well as intracerebral vasculature. Modern multidetector CTA produces images with a high resolution of, not only the contrast-filled lumen, but also of the vessel wall and the surrounding soft tissues. Multiple studies have verified the ability of CTA to provide an accurate representation of the degree of carotid stenosis in comparison to digital subtraction angiography, both for moderate and high-grade stenosis. Because of its fast and accurate vessel imaging, CT angiography is increasingly used in the assessment of carotid artery stenosis. Case Outline. A 37-year-old female patient was admitted at the Vascular Surgery Clinic of the Institute for Cardiovascular Diseases 'Dedinje', Belgrade, for angiography and endovascular procedure of a high-grade stenosis of the left common carotid artery based on Multislice CT findings brought by the patient. She complained of problems which we considered to be the result of cerebral circulation ischemia. After detailed diagnostic procedures, we concluded that no pathological lesions could be verified either on the left common carotid artery or other supraaortic branches. Therefore, the patient was discharged for further neurological examinations. Conclusion. Although Multislice CTA has many advantages over classical angiography, its validity should be taken with reserve, especially in younger patients.

scholarly journals Ligadura de arteria carótida común y exsanguinación como modelo experimental de isquemia cerebral focal en ratas

2018 ◽  
pp. 126-131
Keyword(s):  
Cerebral Ischemia ◽  
Basal Ganglia ◽  
Carotid Artery ◽  
Common Carotid Artery ◽  
Focal Cerebral Ischemia ◽  
Left Common Carotid Artery ◽  
Male Rats ◽  
Circulating Blood Volume ◽  
Brain Artery ◽  
Experimental Group

Ligadura de arteria carótida común y exsanguinación como modelo experimental de isquemia cerebral focal en ratas Ligation of common carotid artery and exsanguination as experimental model of focal cerebral ischemia in rats  Luz Marina Guerrero Espino Universidad Nacional de Trujillo, Calle Salaverry N⁰545-Trujillo, Perú DOI: https://doi.org/10.33017/RevECIPeru2013.0017/ Resumen La isquemia cerebral   es el proceso fisiopatológico caracterizado por la disfunción de una porción del tejido cerebral secundario a la disminución del flujo en una arteria cerebral concreta.  La mejor herramienta que se dispone hoy para el estudio de la fisiopatología de la isquemia cerebral son los modelos experimentales, que permiten abordar de manera simple el cuidado de esta afección que se caracteriza por su complejidad y heterogeneidad. Considerando que  las investigaciones sobre este campo es ilimitada, no solo por la trascendencia sino por el costo social de la enfermedad  ,el estudio de nuevas metodologías experimentales permitirán alcanzar mejores herramientas con rigor científico para el conocimiento fisiopatológico, terapéutico y preventivo de la enfermedad isquémica cerebral.Por lo que nos propusimos  determinar si la ligadura de arteria carótida común izquierda y exsanguinación     puede ser utilizada como modelo de isquemia cerebral focal en ratas. Se usaron 36 ratas, machos de 8 a 9 semanas de edad, con 200 ± 20gr de peso, que se mantuvieron en condiciones estándar de iluminación, ciclos diarios de 12 horas de luz y 12 de oscuridad, a una temperatura ambiente de 24-25°C, los especímenes fueron distribuidas en dos grupos: Grupo Sham o seudo operado y Grupo Experimental (operado). Se procedió a la sangría por punción cardiaca, y se extrajo de cada rata el 10% del volumen de sangre circulante. Bajo condiciones de asepsia y antisepsia, se realizó una incisión en la línea media del cuello y diseccionó la piel, tejido subcutáneo y músculo hasta lograr identificar la arteria carótida común (ACC) izquierda y se ligó con sutura Nylon 5-0 para interrumpir la circulación sanguínea de manera ipsilateral, se suturó la herida y se administró lidocaína, finalmente se dejó descansar al animal a una temperatura ligeramente mayor a la ambiental en cámaras previamente confeccionadas. Luego de 24 horas de aplicar la cirugía, se sacrificaron los especímenes por sobredosis de anestésico y se realizó la remoción del cerebro y el análisis histopatológico de secciones coronales en tres regiones neocortex, hipocampo y ganglios basales, por ser las áreas más vulnerables a daño en una lesión isquémica. Se encontró que las mayores características neuronales que indican daño celular se manifestaron en el Grupo Experimental con un p‹0.01 y la zona con mayor incidencia de daño es el ganglio basal, p ‹0.01. Se concluyó que la ligadura de arteria carótida común izquierda y ex sanguinación produce daños neuronales localizados y la zona más afectada es el ganglio basal. Descriptores:  isquemia cerebral focal, ligadura arteria carótida común ex sanguinación. Abstract Cerebral ischemia is the pathophysiological process characterized by dysfunction of a portion of brain tissue secondary to decreased flow in specific brain artery. The best tool available today to study the pathophysiology of cerebral ischemia are experimental models, which allow a simple way to address the care of the condition which is characterized by complexity and heterogeneity. Whereas research on this field is unlimited, not only because of the importance but by the social cost of the disease, the study of new experimental methodologies to achieve better tools for scientific rigor in pathophysiological knowledge, treatment and prevention of cerebral ischemic disease. So we set out to determine whether the common carotid artery ligation and ex sanguination left can be used as a model of focal cerebral ischemia in rats. We used 36 male rats of 8 to 9 weeks of age, with 200 ± 20g of weight, were maintained in standard lighting conditions, daily cycles of 12 hours of light and 12 of darkness were used at an ambient temperature of 24-25 ° C, the specimens were divided into two groups: Sham Groups and Experimental Group (operated). We proceeded to the bleeding via cardiac puncture, and extracted from each rat 10% of circulating blood volume. Under aseptic and antiseptic conditions, an incision was made in the midline of the neck and dissected the skin, subcutaneous tissue and muscle to be able to identify the left common carotid artery (CCA) and ligated with 5-0 nylon suture to interrupt circulation way of ipsilateral blood, the wound was sutured and received lidocaine finally allowed to rest the animal at a slightly higher environmental chambers previously made temperature. After 24 hours of surgery applied, the specimens were sacrificed by overdose of anesthetic and removal of the brain and histopathological analysis of coronal sections in three regions neocortex, hippocampus and basal ganglia was performed, being the most vulnerable areas to damage ischemic injury. It was found that the major characteristics that indicate neuronal cell damage demonstrated in the experimental group with p <0.01 and the area with the highest incidence of injury is the basal ganglia, p <0.01. It was concluded that ligation of left common carotid artery and ex sanguinación produces localized neuronal damage and the most affected area is the basal ganglia. Keywords: Focal cerebral ischemia, ligation of left common carotid artery and ex sanguination

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