1,272 results match your criteria: "Vertebral Artery Atherothrombosis"

Objective: Tumors in the ventral craniocervical junction (CCJ) pose unique challenges, particularly in children. The potential constraints with endoscopic approaches to tumors extending inferiorly and laterally and the risk of CSF leakage can be exacerbated in the pediatric population. Here, the authors present their experience with the extreme lateral transodontoid (ELTO) approach in children with large ventral CCJ tumors as an alternative or complement to anterior approaches.

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Introduction: Carotid endarterectomy (CEA) is a surgery aimed at removing atherosclerotic plaque from the carotid artery. There are classical and eversion CEA techniques. The eversion technique is the most popular because it does not require the use of implants.

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Aneurysms in the V1 segment of the extracranial vertebral artery are extremely rare. Furthermore, half of the cases are giant aneurysms larger than 25 mm. This study reports a case of unruptured giant V1 aneurysm of the right vertebral artery that was successfully treated with endovascular coil embolization.

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Article Synopsis
  • Vertebral artery dissection (VAD) is a rare but serious condition caused by tearing in the vertebral artery, leading to symptoms like headache and dizziness, and requires timely diagnosis for better outcomes.
  • A young male patient experienced severe headache and seizures, and imaging revealed bilateral VAD and complications like brainstem infarcts, but digital subtraction angiography missed the dissection.
  • High-resolution magnetic resonance imaging (HRMRI) successfully confirmed the diagnosis of VAD and supported the patient's treatment plan, ultimately leading to significant recovery after rehabilitation.*
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Background: Iatrogenic vertebral artery injury during surgery can cause pseudoaneurysm, hemorrhage, thrombosis, ischemia, or death. Strategies to prevent cerebrovascular embolic complications include surgical ligation, endovascular stenting, and/or antiplatelet therapy.

Observations: A 73-year-old female with a known right vertebral artery occlusion underwent a C2-3 laminectomy, complicated by left vertebral artery injury and occlusion with subsequent posterior circulation ischemia.

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Article Synopsis
  • - A 24-year-old male experienced a posterior circulation ischemic stroke due to vertebral artery insufficiency caused by an unstable os odontoideum, highlighting the rare but serious risks associated with atlantoaxial instability and dislocation.
  • - Clinical evaluations revealed recurrent limb numbness and weakness linked to thrombosis in the left vertebral artery, leading to effective treatment through antiplatelet therapy and surgical intervention.
  • - The case underscores the importance of considering unstable os odontoideum as a potential cause for unexplained strokes in young individuals, particularly young males, and stresses the need for targeted imaging to assess vertebral artery injuries.
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Repeated basilar tip occlusion associated with atlantooccipital assimilation: A case report.

J Stroke Cerebrovasc Dis

December 2024

Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan; Department of Neurosurgery, Tokyo General Hospital, Tokyo, Japan.

Article Synopsis
  • An 82-year-old man experienced multiple strokes caused by vertebral artery dissection linked to a condition called atlanto-occipital assimilation.
  • Despite attempts to treat him with thrombectomy and medication changes, he suffered from recurring strokes due to damage to the vertebral artery and abnormal neck movements.
  • This case emphasizes the rare connection between atlanto-occipital assimilation and strokes, underlining the need to consider structural issues in stroke treatment.
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Article Synopsis
  • * The patient was treated using a hybrid procedure that combined open surgery to remove blood clots with endovascular techniques to protect the vertebral artery from embolic issues.
  • * Post-procedure, the patient regained normal pulse and function in the affected arm, and no signs of stroke were found; however, the case highlights that there are few documented instances of using embolic protection in such urgent cases.
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Article Synopsis
  • Thromboembolic (TE) events, which can arise even with proper dual antiplatelet therapy, are serious complications following flow diversion (FD) procedures used to treat aneurysms, leading to significant morbidity and mortality.
  • A study was conducted on 651 FD procedures in 591 patients from 2013 to 2023, revealing a TE event rate of 5.8%, with permanent deficits in 20 patients and 4 fatalities linked to vascular occlusions.
  • Factors such as aspirin resistance, age, and aneurysm characteristics were identified as predictors for the occurrence of TE events, particularly highlighting the high morbidity associated with large-vessel occlusions in the middle cerebral artery.
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Background And Importance: Partially thrombosed vertebral artery aneurysms (PTVAs) are rare, most of which are not easy to treat. Furthermore, endovascular treatment of PTVAs may not have favorable outcomes. The relationship between PTVAs and well-developed vasa vasorum (VV), including the mechanism of aneurysm growth, has been reported, but there are no reports of imaging findings by digital subtraction angiography (DSA).

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Although endothelial damage has been hypothesized to be associated with coronavirus disease 2019 (COVID-19)-related cerebral infarction based on the specificity of the viral cellular invasion pathway, no case has been reported to date. We herein report a 51-year-old Japanese woman who presented with neck pain one week after COVID-19 infection. Computed tomography and magnetic resonance imaging revealed inflammation of the carotid and vertebral arteries.

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Cerebrovascular complications from blunt trauma to the skull base, though rare, can lead to potentially devastating outcomes, emphasizing the importance of timely diagnosis and management. Due to the insidious clinical presentation, subtle nature of imaging findings, and complex anatomy of the skull base, diagnosing cerebrovascular injuries and their complications poses considerable challenges. This article offers a comprehensive review of skull base anatomy and pathophysiology pertinent to recognizing cerebrovascular injuries and their complications, up-to-date screening criteria and imaging techniques for assessing these injuries, and a case-based review of the spectrum of cerebrovascular complications arising from skull base trauma.

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Purpose: This study aims to compare the efficacy and safety of using overlapping low-profile visualized intraluminal support (LVIS) devices and flow diversion (FD) for the treatment of unruptured vertebral artery dissection (VAD) in the V3-V4 segments.

Methods: The clinical and imaging data of 71 patients with unruptured VAD in the V3-V4 segments who underwent either dual LVIS stenting (d-LVIS group) or single FD stenting (FD group) at our center from September 2014 to December 2021 were retrospectively analyzed.

Results: Immediate postoperative angiography revealed no significant difference in the degree of occlusion between the two groups in treating vertebral artery dissecting aneurysms (with or without noncompact coiling).

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Article Synopsis
  • - The case describes a patient with untreated hypertension exhibiting symptoms consistent with Wallenberg syndrome, such as dizziness, vomiting, and altered consciousness, emphasizing the importance of recognizing these symptoms early.
  • - Comprehensive assessments, including MRI and MRA, revealed ischemic lesions caused by basilar artery thrombosis related to the patient's hypertension, highlighting the critical role of imaging in diagnosing cerebrovascular conditions.
  • - The patient's lack of treatment for hypertension and related risks underlines the necessity for proactive patient care and risk factor management to prevent serious complications like cerebral artery thrombosis.
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Background: May-Thurner syndrome (MTS) is an extrinsic venous compression by the arterial system against bony structures in the iliocaval territory. The most common variant of MTS is due to compression of the left iliac vein between the overlying right common iliac artery and the fifth lumbar vertebrae. The prevalence of MTS is unknown; therefore, there are only a few publications about MTS in kidney transplant recipients.

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Article Synopsis
  • * The echocardiogram identified significant heart defects, including an interrupted aortic arch and a large ventricular septal defect, but the presence of a patent ductus arteriosus prevented immediate complications from this reversed flow.
  • * Ultimately, the infant was diagnosed with DiGeorge syndrome, underwent corrective surgery for the interrupted aortic arch, and restored normal blood flow in the basilar artery, highlighting the critical nature of recognizing these congenital vascular anomalies.
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Vascular anomalies known as dural arteriovenous fistulas (DAVFs) occur when arteries that emerge from carotid or vertebral artery branches empty straight into the dural venous sinuses. A 16-year-old male patient at the center of this case study initially arrived at the hospital with symptoms of generalized tonic-clonic seizures and headaches accompanied by vomiting, followed by right-sided hemiparesis and subsequently left-sided hemiparesis. An MRI brain with MR angiography was performed, revealing an abnormal fistulous connection between the sigmoid and transverse sinus and the branches of the bilateral external carotid and right internal carotid artery.

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Article Synopsis
  • - The study investigates the 1-year outcomes of endovascular repair for blunt thoracic aortic injury (BTAI) using the GORE® TAG® Thoracic Branch Endoprosthesis, focusing on preserving the left subclavian artery (LSA).
  • - Nine patients (8 male, 1 female) with grade 3 BTAI were treated, revealing successful procedures with no serious complications, such as strokes or mortalities, during the 12 months of follow-up.
  • - Results indicate that this method is a viable option for treating zone 2 BTAI, potentially reducing the need for sacrificing the LSA and improving patient outcomes in the long term.
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A rare case of bilateral subclavian artery agenesis.

J Vasc Surg Cases Innov Tech

April 2024

Division of Vascular Surgery, Vanderbilt University Medical Center, Nashville, TN.

Article Synopsis
  • Arterial agenesis is a rare condition affecting various arteries, including the internal and common carotid arteries, as well as the pulmonary artery, but not previously reported for subclavian arteries.
  • A case of a patient with no symptoms was discovered to have bilateral subclavian artery agenesis and an aneurysm in the left subclavian artery.
  • Though asymptomatic, the aneurysm was surgically repaired to avoid risks of thrombosis, embolism, and stroke.
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Chiropractic cervical spinal manipulations have several complications and can result in vascular injury, including traumatic dissection of the vertebral arteries. A 43-year-old woman was admitted to the emergency department after performing a self-chiropractic spinal manipulation. She experienced headache and vomiting and was unresponsive with severe hypertension at the time of hospital admission.

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Article Synopsis
  • The study aimed to compare direct vs. indirect revascularization methods for the left vertebral artery in patients needing surgery involving the aortic arch.
  • It found that patients undergoing direct revascularization had higher rates of complications like stroke, death, and nerve injuries compared to those with indirect revascularization via the subclavian artery.
  • Results showed that direct revascularization patients were almost three times more likely to experience severe outcomes and six times more likely to have issues like hoarseness post-surgery.
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Background: In its normal anatomical relationship, the inferior vena cava is located on the right side of the abdominal aorta. Iliac vein compression syndrome (IVCS) is a pathological condition in which a blood clot is formed due to blood flow obstruction when the left common iliac vein is compressed between the right common iliac artery and the vertebral body. Therefore, right-sided IVCS (RIVCS) is rare.

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Background: The efficacy and safety of partial trapping for the treatment of unclippable vertebral artery aneurysms (UVAs) are still questionable. The partial trapping method (proximal or distal occlusion) was used in the treatment of aneurysms to simplify the surgical procedure and avoid postoperative complications.

Methods: This study included 27 patients with UVAs who underwent microsurgical partial trapping between January 2015 and August 2022, and their postoperative outcomes and complications were retrospectively reviewed and evaluated.

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