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Alenezi S, Saleem A, Alenezi A, Alhajri O, Khuraibet S, Ameer A. Sudden unilateral eye pain with vision loss related to carotid stump syndrome; A case report and literature review. Int J Surg Case Rep 2023; 106:108208. [PMID: 37068458 PMCID: PMC10130206 DOI: 10.1016/j.ijscr.2023.108208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 04/07/2023] [Accepted: 04/07/2023] [Indexed: 04/19/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Carotid stump syndrome (CSS) is a rare cause of recurrent ipsilateral cerebrovascular accidents (CVAs) resulting from completely occluded internal carotid artery (ICA). In this condition, hemodynamic and embolic risks are related to cerebral and retinal ischemic strokes. PRESENTATION OF CASE A 65-year-old gentleman with multiple comorbidities, presented to our hospital with a sudden painful unilateral vision loss of the right eye. Head CT was done upon arrival, showing no evidence of ischemic or hemorrhagic brain insult and multiple right frontoparietal old infarct lesions were detected. Central retinal artery occlusion diagnosis was confirmed by an ophthalmologist. CT angiogram of the brain and carotids was done and revealed an obliterated, thrombosed, and non-opacified right internal carotid artery from the carotid bifurcation up to intracranial petrous/foramen lacerum. After taking the patient's surgical consent, right carotid stump endarterectomy and ligation of the stump under general anesthesia was done and the postoperative period was uneventful. CLINICAL DISCUSSION CSS is an uncommon underlying etiology, causing recurrent stroke events. The clinical features of this syndrome include cerebral and ophthalmology symptoms. Diagnosis of CSS relies on imaging modalities. Internal carotid artery stump surgical excision through the ipsilateral ECA endarterectomy is the gold standard for CSS treatment. CONCLUSION Despite being a rare entity, CSS is a treatable cause of retinal embolic events TIAs. Therefore, it is important to raise awareness of such condition. The presented case demonstrates the diagnosis, management and prognosis of CSS.
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Affiliation(s)
- Saqer Alenezi
- Vascular surgery department, Jaber Al Ahmad Hospital, Kuwait.
| | - Athary Saleem
- Vascular surgery department, Jaber Al Ahmad Hospital, Kuwait
| | - Ali Alenezi
- Vascular surgery department, Jaber Al Ahmad Hospital, Kuwait
| | - Omar Alhajri
- Vascular surgery department, Jaber Al Ahmad Hospital, Kuwait
| | - Salma Khuraibet
- Vascular surgery department, Jaber Al Ahmad Hospital, Kuwait
| | - Ahmed Ameer
- Vascular surgery department, Jaber Al Ahmad Hospital, Kuwait
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Baker C, Sherrod B, Gamboa NT, Taussky P, Grandhi R. Carotid Stump Syndrome With Stent-Assisted Coil Embolization. Cureus 2022; 14:e22746. [PMID: 35371850 PMCID: PMC8970411 DOI: 10.7759/cureus.22746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2022] [Indexed: 11/05/2022] Open
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Nagalapuram V, Tharumia Jagadeesan C, Ramasamy B. Carotid Stump Syndrome: An Uncommon Cause of Recurrent Ipsilateral Strokes. Cureus 2021; 13:e12688. [PMID: 33604220 PMCID: PMC7880803 DOI: 10.7759/cureus.12688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Carotid stump syndrome is a rare cause of recurrent cerebrovascular accidents. Carotid stump is the patent proximal remnant below the completely occluded internal carotid artery (ICA). Cerebral and retinal ischemic symptoms seen after complete occlusion of ipsilateral ICA is known as carotid stump syndrome. Known for causing recurrent ipsilateral cerebrovascular accidents, it is a potentially treatable entity. The therapeutic goal is medical management with a statin, dual anti-platelet therapy along with surgical intervention either with an endovascular repair or carotid endarterectomy. Herein, we present a case of carotid stump syndrome managed medically.
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Affiliation(s)
- Vishnu Nagalapuram
- Internal Medicine, The University of Alabama at Birmingham (UAB) School of Medicine, Montgomery, USA
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Quintas-Neves M, Xavier SA, Santos MR, Silva AR, Alves JN, Rocha J, Amorim JM. External carotid artery stenting in symptomatic internal carotid artery occlusion. J Clin Neurosci 2020; 78:397-399. [PMID: 32402613 DOI: 10.1016/j.jocn.2020.05.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 05/04/2020] [Indexed: 10/24/2022]
Abstract
We report the case of a patient with an anterior ischemic stroke due to tandem occlusion of the left M2 segment and ipsilateral internal carotid artery (ICA), with concomitant severe stenosis of the ipsilateral external carotid artery (ECA) and contralateral ICA, and moderate stenosis of the left vertebral artery (VA); as thrombectomy was not possible, stenting of the right ICA was performed. Two days after significant recovery, the patient showed neurological deterioration when in upright position, and brain magnetic resonance imaging confirmed decreased cerebral blood flow on the left hemisphere. Stenting of the left ECA and balloon angioplasty of the ipsilateral VA were performed in order to increase collateral flow, with an almost complete resolution of symptoms. This case highlights the importance of assessing the collateralization pattern when an ICA occlusion is present, and the potential need to revascularize an ipsilateral stenotic ECA.
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Affiliation(s)
- Miguel Quintas-Neves
- Neuroradiology Department, Hospital de Braga, Sete Fontes - São Victor, 4710-243 Braga, Portugal.
| | - Sofia Almeida Xavier
- Neuroradiology Department, Hospital de Braga, Sete Fontes - São Victor, 4710-243 Braga, Portugal
| | - Mariana Ribeiro Santos
- Neuroradiology Department, Hospital de Braga, Sete Fontes - São Victor, 4710-243 Braga, Portugal
| | - Ana Rita Silva
- Neurology Department, Hospital de Braga, Sete Fontes - São Victor, 4710-243 Braga, Portugal
| | - José Nuno Alves
- Neurology Department, Hospital de Braga, Sete Fontes - São Victor, 4710-243 Braga, Portugal
| | - Jaime Rocha
- Neuroradiology Department, Hospital de Braga, Sete Fontes - São Victor, 4710-243 Braga, Portugal
| | - José Manuel Amorim
- Neuroradiology Department, Hospital de Braga, Sete Fontes - São Victor, 4710-243 Braga, Portugal
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Xu Z, Wang J, Luo B. Interventional recanalization as a treatment of carotid stump syndrome caused by right internal carotid artery occlusion: A case report. Medicine (Baltimore) 2019; 98:e17152. [PMID: 31574821 PMCID: PMC6775342 DOI: 10.1097/md.0000000000017152] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Carotid stump syndrome is a cerebral infarction caused by an embolus formed subsequent to the vortex of blood flow from the occluded stump, which then moves through the collateral vessels into the brain. The covered stent and stent-assisted coil embolization stump are the effective interventions for the carotid artery stump. PATIENT CONCERNS A 71-year-old man twice experienced left limb weakness; diffusion weighted imaging confirmed the diagnosis of cerebral infarction. Cervical computed tomography angiography, intracranial magnetic resonance angiography, and digital subtraction angiography were conducted to evaluate collateral circulation, intraluminal composition, and shape of the carotid stump. DIAGNOSES The patient was diagnosed with cerebral infarction and right carotid stump syndrome. INTERVENTION The patient underwent interventional recanalization of the occluded internal carotid artery, which relieved his symptoms and led to satisfactory therapeutic outcomes during the clinical follow-up. OUTCOMES A 9-month clinical follow-up revealed no stroke recurrence. LESSONS Interventional recanalization for the carotid artery stump syndrome is feasible. Accurate preoperative evaluation including collateral circulation, intraluminal composition, and shape of the carotid stump can assure a successful vascularization and guided management.
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Affiliation(s)
- Ziqi Xu
- Department of Neurology, The First Affiliated Hospital of College of Medicine
| | - Jinhua Wang
- Department of Neurology Beilun Branch of The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Benyan Luo
- Department of Neurology, The First Affiliated Hospital of College of Medicine
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6
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Dulai M, Elsherif M, Tawfick W, Kavanagh EP, Hynes N, Sultan S. Outcome following open and endovascular intervention for carotid stump syndrome. SAGE Open Med Case Rep 2018; 6:2050313X18779744. [PMID: 29977555 PMCID: PMC6024327 DOI: 10.1177/2050313x18779744] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Accepted: 04/27/2018] [Indexed: 11/22/2022] Open
Abstract
Carotid stump syndrome is defined as the persistence of retinal or cerebral ischaemic events with complete occlusion of the ipsilateral internal carotid artery. The aim of this retrospective cases series was to assess the outcomes for patients with carotid stump syndrome managed with surgical intervention. A series of 11 cases of carotid stump syndrome in nine patients presented to our tertiary vascular centre from October 2004 to February 2016. Indications for intervention were amaurosis fugax, transient ischaemic attacks and stroke. In total, 11 procedures were performed on nine patients including carotid angioplasty and stenting or carotid endarterectomy with patching. The mean follow-up period was 56.6 months. One patient suffered a myocardial infarction 30 days, post-operatively, and one patient was lost to follow-up. In the remaining seven patients, there was a complete resolution of symptoms. There were no incidents of death, stroke, cranial nerve injury, wound haematoma or procedural bleeding. Surgical exclusion of carotid stumps combined with dual antiplatelet agents was found to be a safe and effective treatment method for carotid stump syndrome.
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Affiliation(s)
- Makinderjit Dulai
- Western Vascular Institute, Department of Vascular & Endovascular Surgery, University Hospital Galway, National University of Ireland Galway, Galway, Ireland
| | - Mohamed Elsherif
- Western Vascular Institute, Department of Vascular & Endovascular Surgery, University Hospital Galway, National University of Ireland Galway, Galway, Ireland
| | - Wael Tawfick
- Western Vascular Institute, Department of Vascular & Endovascular Surgery, University Hospital Galway, National University of Ireland Galway, Galway, Ireland
| | - Edel P Kavanagh
- Western Vascular Institute, Department of Vascular & Endovascular Surgery, University Hospital Galway, National University of Ireland Galway, Galway, Ireland.,Galway Clinic, Royal College of Surgeons in Ireland, Galway, Ireland
| | - Niamh Hynes
- Western Vascular Institute, Department of Vascular & Endovascular Surgery, University Hospital Galway, National University of Ireland Galway, Galway, Ireland.,Galway Clinic, Royal College of Surgeons in Ireland, Galway, Ireland
| | - Sherif Sultan
- Western Vascular Institute, Department of Vascular & Endovascular Surgery, University Hospital Galway, National University of Ireland Galway, Galway, Ireland.,Galway Clinic, Royal College of Surgeons in Ireland, Galway, Ireland
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Zhang XU, Shao S, Zheng X, Gao X, Zhang Y. Carotid stump syndrome: A case report. Exp Ther Med 2015; 10:1161-1164. [PMID: 26622457 DOI: 10.3892/etm.2015.2648] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 06/22/2015] [Indexed: 11/05/2022] Open
Abstract
Carotid stump syndrome (CSS) is known to be one of the causes of recurrent ipsilateral ischemic stroke following the occlusion of the internal carotid artery (ICA). The present study describes a case of left CSS in a 50-year-old patient presenting with a central retinal artery embolism following internal carotid and middle cerebral artery occlusion. The central retinal artery embolism was believed to be a consequence of microemboli, which originated from the stump of the occluded ICA, passing into the ophthalmic artery due to external carotid-internal carotid anastomotic channels, although the other possible pathophysiological causes of this condition are discussed. Digital subtraction angiography of the patient showed trickle flow in the occluded ICA during the venous phase, by which the stump emboli may have been transported to the ophthalmic artery. The patient was successfully treated with anticoagulation therapy without surgical or endovascular treatment.
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Affiliation(s)
- X U Zhang
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, P.R. China
| | - Shixiu Shao
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, P.R. China
| | - Xueping Zheng
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, P.R. China
| | - Xiang Gao
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, P.R. China
| | - Yong Zhang
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, P.R. China
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Dakhoul LT, Tawk R. Carotid Stump Syndrome: Case Report and Endovascular Treatment. J Investig Med High Impact Case Rep 2014; 2:2324709614548796. [PMID: 26425620 PMCID: PMC4528906 DOI: 10.1177/2324709614548796] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives. To highlight the case of a patient with multiple transient ischemic attacks and visual disturbances diagnosed with carotid stump syndrome and managed with endovascular approach. Case Presentation. We present the case of a carotid stump syndrome in an elderly patient found to have moderate left internal carotid artery stenosis in response to an advertisement for carotid screening. After a medical therapeutic approach and a close follow-up, transient ischemic attacks recurred. Computed tomographic angiography showed an occlusion of the left internal carotid artery and the presence of moderate stenosis in the right internal carotid artery, which was treated by endovascular stenting and balloon insertion. One month later, the patient presented with visual disturbances due to the left carotid stump and severe stenosis of the left external carotid artery that was reapproached by endovascular stenting. Conclusion. Considerations should be given to the carotid stump syndrome as a source of emboli for ischemic strokes, and vascular assessment could be used to detect and treat this syndrome.
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Affiliation(s)
| | - Rabih Tawk
- Mayo Clinic Hospital, Jacksonville, FL, USA
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Kouvelos GN, Koutsoumpelis AC, Klonaris C, Matsagkas MI. Endovascular Repair of External Carotid Artery Disease. J Endovasc Ther 2012; 19:504-11. [DOI: 10.1583/jevt-12-3886r.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Safety and efficacy of surgical treatment of carotid stump syndrome: pilot study. Ann Vasc Surg 2012; 26:797-801. [PMID: 22622073 DOI: 10.1016/j.avsg.2011.11.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Accepted: 11/24/2011] [Indexed: 11/20/2022]
Abstract
Surgical exclusion of the internal carotid artery (ICA) stump combined with endarterectomy of the external carotid artery is an established treatment approach. The aim of this pilot study was to compare the risk of cerebrovascular events between surgical treatment and best medical treatment in patients with ICA occlusion and carotid stump syndrome. Forty patients (23 males; age: 43-80 years; mean age: 61.1 ± 9.0 years) with carotid occlusion and carotid stump syndrome were enrolled. Ten patients with asymptomatic ICA occlusion and 10 patients with symptomatic ICA occlusion and carotid stump syndrome were enrolled to the best medical therapy group. Patients with chronic ICA occlusion, carotid stump syndrome, and one (15 patients) or recurrent (three patients) episodes of ipsilateral stroke or transient ischemic attack were enrolled to the surgical group. Neurological examination was undertaken on the day of randomization and then every 6 months in all patients for 4 years. All vascular events and death were recorded. Only one vascular event occurred in patients with symptomatic ICA occlusion without recurrent stroke or transient ischemic attack who were treated medically. No other vascular event was noted in the other subgroups. One patient with symptomatic carotid occlusion without recurrent stroke died due to myocardial infarction 6 months after surgery. Surgical treatment of carotid stump syndrome seems to be a safe procedure. Nevertheless, the benefit of a surgical approach in comparison with the best medical treatment is not clear.
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Affiliation(s)
- Amit J. Dwivedi
- University of Louisville Division of Vascular Surgery Louisville, Kentucky
| | - Andrea E. Yancey
- University of Louisville Division of Vascular Surgery Louisville, Kentucky
| | - Charles B. Ross
- University of Louisville Division of Vascular Surgery Louisville, Kentucky
| | - Marvin E. Morris
- University of Louisville Division of Vascular Surgery Louisville, Kentucky
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12
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Mohr J, Mast H. Carotid Artery Disease. Stroke 2011. [DOI: 10.1016/b978-1-4160-5478-8.10022-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Xu DS, Abruzzo TA, Albuquerque FC, Dabus G, Eskandari MK, Guterman LR, Hage ZA, Hurley MC, Hanel RA, Levy EI, Nichols CW, Ringer AJ, Batjer HH, Bendok BR. External Carotid Artery Stenting to Treat Patients With Symptomatic Ipsilateral Internal Carotid Artery Occlusion. Neurosurgery 2010; 67:314-21. [PMID: 20644416 DOI: 10.1227/01.neu.0000371728.49216.3b] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
BACKGROUND
The external carotid artery (ECA) anastomoses in many distal territories supplied by the internal carotid artery (ICA) and is an important source of collateral circulation to the brain. Stenosis of the ECA in ipsilateral ICA occlusion can produce ischemic sequelae.
OBJECTIVE
To examine the effectiveness of ECA stenting in treating symptomatic ipsilateral ICA occlusion.
METHODS
We retrospectively reviewed patient databases from 5 academic medical centers to identify all individuals who underwent ECA stenting after 1998. For all discovered cases, coinvestigators used a common submission form to harvest relevant demographic information, clinical data, procedural details, and follow-up results for further analysis.
RESULTS
Twelve patients (median age, 66 years; range, 45–79 years) were identified for our cohort. Vessel disease involvement included severe ECA stenosis ≥ 70% in 11 patients and ipsilateral ICA occlusion in all patients. Presenting symptoms included signs of transient ischemic attack, stroke, and amaurosis fugax. ECA stenting was associated with preservation of neurological status in 11 patients and resolution of symptoms in 5 patients at a median follow-up time of 26 months (range, 1–87 months; mean, 29 months). Symptomatic in-stent restenosis did not occur within any patient during the follow-up course.
CONCLUSION
We found ECA stenting in symptomatic ipsilateral ICA disease to be a potentially effective strategy to preserve neurological function and to relieve ischemic symptoms. Further investigation with larger studies and longer follow-up periods is warranted to elucidate the true indications of this management strategy.
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Affiliation(s)
- David S. Xu
- Departments of Neurological Surgery and Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Todd A. Abruzzo
- Departments of Neurology, Neurological Surgery, and Radiology, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | | | - Guilherme Dabus
- Departments of Neurological Surgery and Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Mark K. Eskandari
- Department of Surgery, Division of Vascular Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Lee R. Guterman
- Department of Neurological Surgery, Buffalo Neurosurgery Group, West Seneca, New York
| | - Ziad A. Hage
- Departments of Neurological Surgery and Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Michael C. Hurley
- Departments of Neurological Surgery and Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Ricardo A. Hanel
- Department of Neurological Surgery, Mayo Clinic, Jacksonville, Florida
| | - Elad I. Levy
- Departments of Neurological Surgery and Radiology and Toshiba Stroke Research Center, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York
| | | | - Andrew J. Ringer
- Departments of Neurological Surgery and Radiology, The Neuroscience Institute, University of Cincinnati College of Medicine and Mayfield Clinic, Cincinnati, Ohio
| | - H. Hunt Batjer
- Departments of Neurological Surgery and Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Bernard R. Bendok
- Departments of Neurological Surgery and Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Carotid stump syndrome: pathophysiology and endovascular treatment options. Cardiovasc Intervent Radiol 2010; 34 Suppl 2:S48-52. [PMID: 20552197 DOI: 10.1007/s00270-010-9906-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2010] [Accepted: 05/19/2010] [Indexed: 11/27/2022]
Abstract
Carotid stump syndrome is one of the recognised causes of recurrent ipsilateral cerebrovascular events after occlusion of the internal carotid artery. It is believed that microemboli arising from the stump of the occluded internal carotid artery or the ipsilateral external carotid artery can pass into the middle cerebral artery circulation as a result of patent external carotid-internal carotid anastomotic channels. Different pathophysiologic causes of this syndrome and endovascular options for treatment are discussed.
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Carrafiello G, Delodovici ML, Piffaretti G, Castelli P. Endovascular treatment of carotid stump syndrome. Vasc Endovascular Surg 2009; 43:277-9. [PMID: 19174528 DOI: 10.1177/1538574408327573] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We present the case of a carotid stump syndrome in a 72-year-old woman with a 3-day history of recurrent transient ischemic attacks. Computed tomographic angiography showed the occlusion of the ipsilateral internal carotid artery, and the presence of an internal stump with ophthalmic reverse flow, confirming the suspect of a stump syndrome. The patient underwent stent-graft exclusion of the carotid stump; she was last seen 12 months after the procedure when she remained totally asymptomatic.
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Affiliation(s)
- Gianpaolo Carrafiello
- Interventional Radiology, Department of Radiology, University of Insubria, Varese, Italy
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Abstract
Atherosclerotic occlusive lesions of the common carotid artery (CCA), the internal carotid artery (ICA), and the intracranial branches are amenable to angioplasty and stenting. Non atheromatous occlusive lesions caused by fibromuscular dysplasia, arteritis, or trauma may also be treated by image guided intervention in selected patients. Aneurysmal lesions of the CCA, ICA and the intracranial branches of degenerative, mycotic or traumatic etiologies, as well as carotid cavernous fistulae are mostly best treated by embolization. Technological developments continuously expand the indications of interventional treatment in these vascular territories.
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Affiliation(s)
- George Magoufis
- Department of Interventional Neuroradiology, Metropolitan Hospital, Voula, Greece
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