Figure 24 - uploaded by Mansour Mirfakhraee
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This lateral view of the left common carotid angiogram, in another patient, demonstrates filling of the distal internal carotid artery through collateral circulation. Note the retrograde filling of the more proximal portion of the internal carotid artery (arrows). There is beginning slow antegrade filling of the internal carotid artery (open arrow). STA = superficial temporal artery.
Source publication
It appears thatpercutaneous angioplasty can be ofvalue in selected cases of vascular disease involving the brachiocephalic vessels.
Citations
The obstructing thrombus in a totally occluded internal carotid artery may act as a source of cerebral emboli. These emboli traverse the external carotid and ophthalmic arteries and enter the intracranial circulation via retrograde collateral pathways. Surgical treatment can result in complete abatement of symptoms in selected patients. The authors describe internal carotid "stump" syndrome in a 47-year-old man and discuss the options for surgical management.
Nineteen patients underwent a total of 21 stump angioplasty procedures for an occluded internal carotid artery. Indications for surgery included the preparation of the donor vessel for a subsequent extracranial-intracranial bypass procedure, the occurrence of emboli to the intracranial vasculature from the external carotid artery circulation, and the association with symptomatic occlusive disease of the external carotid artery accompanying occlusion of the ipsilateral internal carotid artery.
The technique utilized and the results obtained in these 19 patients are presented. In select patients, the removal of an occluded internal carotid artery stump via a stump angioplasty is beneficial in preventing the catastrophic sequela of embolic cerebrovascular disease.
