Interventional Neurovascular Approaches to the Basilar and Vertebral Arteries

2015 ◽  
pp. 686-689
Author(s):  
Randall T. Higashida ◽  
Van V. Halbach ◽  
Christopher F. Dowd ◽  
Kenneth Fraser ◽  
Tony Smith ◽  
...  
Keyword(s):  
VASA ◽  
2010 ◽  
Vol 39 (1) ◽  
pp. 85-93 ◽  
Author(s):  
Schubert

The subclavian steal effect indicates atherosclerotic disease of the supraaortic vessels but rarely causes cerebrovascular events in itself. Noninvasive imaging providing detailed anatomic as well as hemodynamic information would therefore be desirable. From a group of 25 consecutive patients referred for MR angiography, four with absent or highly attenuated signal in one of the vertebral arteries on 3D multislab time-of-flight MR angiography were selected to undergo 3D time-resolved contrast-enhanced MR angiography. The time-resolved 3D contrast series (source images and MIPs) were evaluated visually and by graphic analysis of time-intensity curves derived from the respective V1 and V3 segments of both vertebral arteries on the source images. In two cases with high-grade proximal left subclavian stenosis, time-resolved 3D ce-MRA was able to visualise retrograde contrast filling of the left VA. There was a marked delay in time-to-peak between the left and right V1 segments in one case and a shallower slope of enhancement in another. In the other two cases, there was complete or collateralised segmental occlusion of the VAs.


2016 ◽  
Vol 18 (9) ◽  
pp. 32-36
Author(s):  
M.Yu. Maximova ◽  
◽  
S.I. Skrylev ◽  
Zh.N. Sermagambetova ◽  
P.A. Fedin ◽  
...  

1993 ◽  
Vol 43 (4) ◽  
pp. 439-445
Author(s):  
TADAO MATSUSHIMA ◽  
HIROSHI NAKAGAWA ◽  
JINICHI KOIZUMI ◽  
KAZUO WATANABE

2021 ◽  
pp. 154431672110023
Author(s):  
Winnie Nguyen ◽  
Tammy Albanese ◽  
Vanessa Tran ◽  
Anne Moore ◽  
Laligam Sekhar

This is a case report of a 35-year-old female pedestrian struck by a semi-truck. computed tomographic angiography (CTA) revealed a pseudoaneurysm at the proximal brachiocephalic artery measuring 1.8 cm in cranio-caudal length and 1.2 × 0.6 cm transverse. Just distal to the pseudoaneurysm, there was severe luminal narrowing caused by either a dissection flap or mural thrombus. Due to profound left-sided weakness, transcranial Doppler ultrasound was performed which demonstrated “hesitant” waveforms in the right middle cerebral and right vertebral arteries secondary to proximal obstruction. Hesitant waveforms display mid-systolic velocity deceleration and may also be referred to as the “bunny” waveform. Emboli monitoring of the right middle cerebral and basilar arteries were positive for active embolization


2021 ◽  
Vol 38 (01) ◽  
pp. 053-063
Author(s):  
Ananth K. Vellimana ◽  
Jayson Lavie ◽  
Arindam Rano Chatterjee

AbstractCervical carotid and vertebral artery traumatic injuries can have a devastating natural history. This article reviews the epidemiology, mechanisms of injury, clinical presentation, and classification systems pertinent to consideration of endovascular treatment. The growing role of modern endovascular techniques for the treatment of these diseases is presented to equip endovascular surgeons with a framework for critically assessing patients presenting with traumatic cervical cerebrovascular injury.


1989 ◽  
Vol 9 (5) ◽  
pp. 640-645 ◽  
Author(s):  
V. MacMillan

In this study, the cerebral hemisphere content of calcium as well as selected parameters of oxidative metabolism and electrophysiological function were assessed in normoglycemic and hyperglycemic rats that were exposed to ischemia produced by electrocautery of the vertebral arteries and reversible occlusion of the carotid arteries. In hyperglycemic animals, 0.5 h of ischemia was associated with large accumulations of lactate (27 mmol/kg), whereas normoglycemic animals showed lesser lactate accumulation (17 mmol/kg). At this sampling time (0.5 h of ischemia), both groups of ischemic animals showed tissue calcium contents that were unchanged from preischemic control levels. In normoglycemic animals, release of the carotid clamps and recirculation for 1.5–24 h was associated with normalization of lactate, ATP and phosphocreatine, clinical behavior, and EEC During this 24 h of recirculation, cerebral calcium levels showed no changes. Hyperglycemic ischemic animals recirculated for 1.5–24 h showed a persistent lactic acidosis, depressed ATP and phosphocreatine, gross EEG abnormalities, seizures, and a high mortality rate. Again, during this 24 h period, cerebral calcium content showed no changes from preischemic control or from the matched saline-treated group. These data suggest that significant accumulation of calcium in brain tissue is not an early event in ischemic-hyperglycemic brain damage, and thus does not provide support for a role of calcium in the production of this form of ischemic damage.


Angiology ◽  
1989 ◽  
Vol 40 (8) ◽  
pp. 716-720 ◽  
Author(s):  
Graziano Arnetoli ◽  
Andrea Amadori ◽  
Paolo Stefani ◽  
Giuseppe Nuzzaci

1997 ◽  
Vol 3 (2_suppl) ◽  
pp. 194-197
Author(s):  
M. Sawada ◽  
N. Hashimoto ◽  
S. Nishi ◽  
Y. Akiyama

We investigate the safety and/or risk of PTA for vertebral and subclavian artery stenosis by monitoring embolic signals using transcranial Doppler (TCD) ultrasonography. Twelve consecutive patients undergoing PTA for subclavian and vertebral artery stenosis of atherosclerotic origin were studied. Before, during and after PTA, TCD monitoring was performed to detect embolic signals for 30 minutes at each time. No embolic signals were detected in any patient before angioplasty. During angioplasty, one embolic signal was detected immediately after balloon deflation in one of 12 patients. Several embolic signals were detected after the procedure in six of 12 patients, but thereafter embolic signals became less frequent in number. Three days after angioplasty, embolic signals were not detected in any patient. TCD monitoring could be a useful modality for detection of microemboli during and after PTA in the posterior circulation. Our present study suspected that subclinical microemboli are released from the dilated vessels for three days after vertebral and subclavian PTA and anticoagulant or antiplatelet therapies may prevent embolic complications after the procedure.


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