title: Concomitant asymptomatic internal carotid artery and persistent primitive hypoglossal artery stenosis treated by endovascular stenting with proximal embolic protection.
abstract: The persistent primitive hypoglossal artery (PPHA) is a rare fetal variant of carotid-basilar anastomosis that increases the risk of ischemia and embolic infarction within the posterior cerebral circulation in patients with carotid stenosis proximal to the origin of the PPHA. A man presented with severe stenosis of the right internal carotid artery with extension to the origin of a PPHA. The area of stenosis was at a high position, which contraindicated carotid endarterectomy. Therefore, stenting was performed with proximal reversal of flow embolic protection. The unique anatomic and technical challenges associated with this case are reviewed in detail.
authors.affiliation: Department of Neurology, the Third Hospital of Shijiazhuang, Shijiazhuang, China.
authors.forename: Li
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Xuan Wu Hospital, affiliated with Capital Medical University, Beijing, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Song
authors.affiliation: Department of Neurology, the Third Hospital of Shijiazhuang, Shijiazhuang, China.
authors.forename: Lifeng
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, Xuan Wu Hospital, affiliated with Capital Medical University, Beijing, China. Electronic address: jiaoliqun@gmail.com.
authors.forename: Liqun
authors.initials: L
authors.lastname: Jiao
authors.affiliation: Department of Neurosurgery, Xuan Wu Hospital, affiliated with Capital Medical University, Beijing, China.
authors.forename: Yanfei
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, Xuan Wu Hospital, affiliated with Capital Medical University, Beijing, China.
authors.forename: Yabing
authors.initials: Y
authors.lastname: Wang
mesh_terms: D015901:Angiography, Digital Subtraction; D000800:Angioplasty, Balloon / Q000295:instrumentation*; D058070:Asymptomatic Diseases; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000503:physiopathology; D016893:Carotid Stenosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D057505:Embolic Protection Devices; D006801:Humans; D008297:Male; D012720:Severity of Illness Index; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D054079:Vascular Malformations / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D014654:Vascular Patency