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Carotid Endarterectomy for Internal Carotid Artery Stenosis Associated with Persistent Primitive Hypoglossal Artery : Efficacy of Intraoperative Multi-modality Monitoring

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Title: Carotid Endarterectomy for Internal Carotid Artery Stenosis Associated with Persistent Primitive Hypoglossal Artery : Efficacy of Intraoperative Multi-modality Monitoring
Authors: Kawabori, M.1 Browse this author →KAKEN DB
Kuroda, S. Browse this author
Yasuda, H. Browse this author
Hokari, M. Browse this author
Nakayama, N. Browse this author
Saito, H. Browse this author
Iwasaki, Y. Browse this author
Authors(alt): Kawabori, Masahito1
Keywords: persistent primitive hypoglossal artery
carotid stenosis
cerebral infarction
carotid endarterectomy
intraoperative angiography
Issue Date: Oct-2009
Publisher: Thieme
Journal Title: Minimally invasive neurosurgery : MIN
Volume: 52
Issue: 05/06
Start Page: 263
End Page: 266
Publisher DOI: 10.1055/s-0029-1243243
PMID: 20077371
Abstract: Persistent primitive hypoglossal artery (PPHA) is a rare vascular anomaly and is usually asymptomatic. However, the PPHA may cause multi-territorial infarction when complicated by the internal carotid artery (ICA) stenosis. In this report, we describe a 73-year-old male who simultaneously developed cerebral infarction in both carotid and vertebrobasilar territories due to ICA stenosis associated with ipsilateral PPHA. The PPHA mainly provided blood flow to the vertebrobasilar territory in this case, because the bilateral vertebral arteries were markedly hypoplastic. He underwent carotid endarterectomy under internal shunting. Intraoperative multi-modality monitoring including angiography, motor evoked potential, and near infrared spectroscopy was very useful to avoid ischemic complications during surgery. Postoperative course was uneventful. It should be reminded that persistent carotid-basilar anastomosis can cause multi-territorial cerebral infarction mimicking cardiogenic embolism and may be a candidate for aggressive prophylactic intervention, when occlusive lesions develop in the carotid artery. It is very important to monitor hemodynamic and/or electrophysiological status in both carotid and verebrobasilar territories to perform carotid endarterectomy safely in such cases.
Rights: © 2009 Georg Thieme Verlag
Type: article (author version)
URI: http://hdl.handle.net/2115/70792
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 川堀 真人

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