We present a case of an adult with concurrent severe aortic coarctation, bilateral carotid artery stenosis, and anomalous right subclavian artery, posing the interventional dilemma of accepting potential cerebral hyperperfusion syndrome vs hypoperfusion ischemic injury. Transcatheter stenting of the aortic coarctation was successfully performed without any neurological deficits. ().
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http://dx.doi.org/10.1016/j.jaccas.2022.101693 | DOI Listing |
J Neurosurg Case Lessons
January 2025
Department of Neurosurgery, Kanto Rosai Hospital, Kanagawa, Japan.
Background: The presence of significant tortuosity in access routes to aneurysms can interfere with catheter guidance and manipulation and significantly impact treatment strategies.
Observations: In this report, the authors combined intentional staged aneurysm embolization with the construction of a new direct access route, which they call a "highway bypass," for a symptomatic posterior circulation cerebral aneurysm that was difficult to access with a catheter. Notably, the highway bypass is used for catheter passage, and technical tips should be considered.
Rheumatol Int
January 2025
Department of Internal Medicine, General Hospital Oberndorf, Teaching Hospital of the Paracelsus Medical University, Salzburg, Austria.
Rheumatoid arthritis (RA) is a chronic autoimmune disease marked by systemic inflammation. While RA primarily affects the joints, its systemic effects may lead to an increased cerebro- and cardiovascular risk. Atherosclerosis of the carotid arteries is a significant risk factor for cerebrovascular events and serves as a surrogate marker for cardiovascular risk.
View Article and Find Full Text PDFNeuroradiology
January 2025
Department of Vascular and Endovascular Surgery, Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
Aims: To test utility of diffusion MRI-derived indices in carotid endarterectomy (CEA), change of diffusion tensor imaging (DTI) metrics, cerebral white matter (WM) volumes were evaluated and predictors of overall mortality determined.
Methods: Prospectively enrolled participants had preoperative, immediate and late postoperative DTI after CEA. WM volumes, DTI metrics (fractional anisotropy, FA; axial, radial, mean diffusivities; AD, RD, MD, respectively) were calculated for the index/contralateral hemispheres at all time points.
Cureus
December 2024
Department of Cardiology, Geetanjali Medical College and Hospital, Udaipur, IND.
Background Carotid artery stenting is a well-established alternative treatment to carotid endarterectomy for carotid artery stenosis for preventing stroke. This study assessed the procedural and clinical outcomes in patients undergoing carotid artery stenting in a tertiary care center in India. Methods A total of 39 patients underwent carotid artery stenting from January 2022 to December 2023, with different embolic protection devices and carotid stents.
View Article and Find Full Text PDFJPRAS Open
March 2025
Department of Plastic and Reconstructive Surgery, University of the Ryukyu Hospital, Okinawa, Japan.
Total pharyngo-laryngo-esophagectomy (TPLE) with free jejunal transplantation (FJT) is the standard reconstructive procedure for hypopharyngeal cancer, typically utilizing the superior thyroid artery as the recipient vessel. However, patient-specific anatomical variations and comorbidities can significantly complicate this surgery. We present a unique case of a 68-year-old male with hypopharyngeal cancer who exhibited multiple challenges, including short stature (126 cm), low weight (35 kg), cervical spondylosis, and a history of vertebroplasty, highlighting the complexities inherent in such reconstructions.
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