Double Embolic Protection During Carotid Artery Stenting with Persistent Hypoglossal Artery
Overview
Affiliations
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.
Iwaki K, Arimura K, Fukuda S, Takagishi S, Kurogi R, Nakamura K J Neurosurg Case Lessons. 2023; 6(17).
PMID: 37871338 PMC: 10599449. DOI: 10.3171/CASE23427.
Yoshida S, Kamatani K, Takigawa K, Tashiro N, Hashiguchi Y, Yasaka M Surg Neurol Int. 2023; 14:308.
PMID: 37810314 PMC: 10559564. DOI: 10.25259/SNI_567_2023.
Rockley M, Ryan S, Nagpal S J Vasc Surg Cases Innov Tech. 2020; 6(4):520-523.
PMID: 33134634 PMC: 7588749. DOI: 10.1016/j.jvscit.2020.08.007.
Huang M, Moisi M, Zwillman M, Volpi J, Diaz O, Klucznik R Cureus. 2016; 8(1):e464.
PMID: 26929891 PMC: 4762695. DOI: 10.7759/cureus.464.
Ryu B, Ishikawa T, Hashimoto K, Shimizu M, Yagi S, Shimizu T Neuroradiol J. 2016; 29(2):115-21.
PMID: 26825135 PMC: 4978312. DOI: 10.1177/1971400915626427.