Double embolic protection during carotid artery stenting with persistent hypoglossal artery.

Publication Title

BMJ Case Rep

Authors

Christine F Silva
Samuel Y Hou, Department of Radiology, Division Neuroimaging and Intervention, New England Center for Stroke Research, Worcester, Massachusetts 01545, USA.Follow
Anna L Kühn
Richard H Whitten
Ajay K Wakhloo

Document Type

Article

Publication Date

5-2-2013

Keywords

Angioplasty; Basilar Artery; Carotid Artery Diseases; Carotid Artery, Common; Carotid Artery, Internal; Carotid Stenosis; Cerebrovascular Circulation; Embolism; Female; Humans; Middle Aged; Risk Factors; Stents

Abstract

A woman presented with 75% stenosis of the right internal carotid artery (ICA) with extension to the origin of a persistent hypoglossal artery (PHA). The PHA is a rare fetal variant of carotid-basilar anastomosis that elevates the risk of ischemia and embolic infarction within the posterior cerebral circulation in patients with carotid disease proximal to the anastomosis. Our case is highly unique because of the extremely rare nature of the PHA with associated ICA stenosis that extended to the PHA. Additionally, a novel treatment approach was employed by stenting and angioplasty while protecting both the anterior and posterior cerebral circulations.

Clinical Institute

Neurosciences (Brain & Spine)

Specialty/Research Institute

Neurosciences

Comments

Samuel Hou is affiliated with Providence St. Joseph Health.