title: Revascularization of occluded internal carotid arteries by hypertrophied vasa vasorum: report of four cases.
abstract: OBJECTIVE
  The vasa vasorum are involved in the pathophysiological development of carotid artery atherosclerosis, providing vascular support to the thickened intima and plaque. When advanced atherosclerosis causes carotid artery occlusion, the vasa vasorum may serve as a means of revascularization.
  
  
  METHODS
  We studied four patients with internal carotid artery occlusion who exhibited revascularization, distal to the occlusion, by small vascular channels that were inconsistent with recanalization through the thrombus. The channels had an angiographic appearance consistent with their being hypertrophied vasa vasorum. Significant collateral circulation was provided by the revascularization.
  
  
  METHODS
  All four patients exhibited adequate collateral circulation and were treated with antiplatelet or anticoagulation medication.
  
  
  CONCLUSIONS
  The vasa vasorum have not been previously reported to contribute to the revascularization of occluded arteries. The four cases presented in this report suggest that the vasa vasorum can be a source of collateral circulation after carotid artery occlusion secondary to atherosclerotic disease.
authors.affiliation: Department of Surgery, University of Michigan Hospitals, Ann Arbor, USA.
authors.forename: G P
authors.initials: GP
authors.lastname: Colon
authors.forename: J P
authors.initials: JP
authors.lastname: Deveikis
authors.forename: L D
authors.initials: LD
authors.lastname: Dickinson
mesh_terms: D000368:Aged; D001161:Arteriosclerosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D002533:Cerebral Angiography; D002548:Cerebral Revascularization; D005260:Female; D006801:Humans; D006984:Hypertrophy; D008297:Male; D008875:Middle Aged; D014651:Vasa Vasorum / Q000000981:diagnostic imaging / Q000473:pathology*