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, 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 / Q000295:instrumentation / Q000379:methods*; D000800:Angioplasty, Balloon / Q000295:instrumentation / Q000379:methods; D001488:Basilar Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging; D001807:Blood Vessel Prosthesis; D002343:Carotid Artery, Internal / Q000002:abnormalities* / Q000000981:diagnostic imaging; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D002560:Cerebrovascular Circulation / Q000502:physiology; D004617:Embolism / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011859:Radiography; D015607:Stents; D016896:Treatment Outcome
keywords: Atherosclerosis; Embolic; Intervention; Stent