title: Double embolic protection during carotid artery stenting with persistent hypoglossal artery.
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.
authors: Department of Radiology, Division Neuroimaging and Intervention, New England Center for Stroke Research, Worcester, Massachusetts 01545, USA.
authors: Christine F
authors: CF
authors: Silva
authors: Samuel Y
authors: SY
authors: Hou
authors: Anna L
authors: AL
authors: Kühn
authors: Richard H
authors: RH
authors: Whitten
authors: Ajay K
authors: AK
authors: Wakhloo
mesh_terms: D017130:Angioplasty / Q000379:methods*; D001488:Basilar Artery / Q000473:pathology / Q000601:surgery; D002340:Carotid Artery Diseases / Q000150:complications* / Q000601:surgery; D017536:Carotid Artery, Common / Q000473:pathology / Q000601:surgery; D002343:Carotid Artery, Internal / Q000473:pathology* / Q000601:surgery; D016893:Carotid Stenosis / Q000150:complications* / Q000601:surgery; D002560:Cerebrovascular Circulation; D004617:Embolism / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D008875:Middle Aged; D012307:Risk Factors; D015607:Stents
keywords: Atherosclerosis; Embolic; Intervention; Stent
references: Acta Radiol Diagn (Stockh). 1976 Mar;17(2):160-6
references: 1274653
references: J Am Coll Cardiol. 2005 Jun 7;45(11):1769-74
references: 15936604
references: J Am Coll Cardiol. 2002 Mar 6;39(5):841-6
references: 11869850
references: Clin Neurol Neurosurg. 2007 May;109(4):364-7
references: 17224233
references: Acta Radiol. 2007 Feb;48(1):116-8
references: 17325936
references: Can J Surg. 1996 Apr;39(2):159-62
references: 8769929
references: Folia Morphol (Warsz). 2007 May;66(2):143-7
references: 17594674
references: Minim Invasive Neurosurg. 2008 Oct;51(5):298-302
references: 18855296
references: N Engl J Med. 2004 Oct 7;351(15):1493-501
references: 15470212
references: Neurol Med Chir (Tokyo). 2010;50(10):921-4
references: 21030806
references: J Cardiovasc Surg (Torino). 2006 Apr;47(2):127-36
references: 16572086
references: Neurosurgery. 1997 Sep;41(3):669-72
references: 9310986