A successful treatment with carotid arterial stenting for symptomatic severe internal carotid artery stenosis with ipsilateral persistent primitive hypoglossal artery and aplasia of the A1 segment of anterior cerebral artery: a case report

CANTAŞDEMİR, MURAT; NUMAN, Fürüzan; SOLAK, SERDAR; YILMAZ, OĞUZ; SÖNMEZ, Bingür; GÜLŞEN, Fatih

A successful treatment with carotid arterial stenting for symptomatic severe internal carotid artery stenosis with ipsilateral persistent primitive hypoglossal artery and aplasia of the A1 segment of anterior cerebral artery: a case report

Fürüzan NUMAN, (İstanbul Üniversitesi, Cerrahpaşa Tıp Fakültesi, Girişimsel Radyoloji Anabilim Dalı, İstanbul, Türkiye)

Fatih GÜLŞEN, (İstanbul Üniversitesi, Cerrahpaşa Tıp Fakültesi, Girişimsel Radyoloji Anabilim Dalı, İstanbul, Türkiye)

Oğuz YILMAZ, (Memorial Hastanesi, Kardiyovasküler Cerrahi Kliniği, İstanbul, Türkiye)

Murat CANTAŞDEMİR, (İstanbul Üniversitesi, Cerrahpaşa Tıp Fakültesi, Girişimsel Radyoloji Anabilim Dalı, İstanbul, Türkiye)

Serdar SOLAK, (İstanbul Üniversitesi, Cerrahpaşa Tıp Fakültesi, Girişimsel Radyoloji Anabilim Dalı, İstanbul, Türkiye)

Bingür SÖNMEZ (Memorial Hastanesi, Kardiyovasküler Cerrahi Kliniği, İstanbul, Türkiye)

Türk Göğüs Kalp Damar Cerrahisi Dergisi

3 2

Yıl: 2013 Cilt: 21 Sayı: 2 Sayfa Aralığı: 440 - 444 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

A successful treatment with carotid arterial stenting for symptomatic severe internal carotid artery stenosis with ipsilateral persistent primitive hypoglossal artery and aplasia of the A1 segment of anterior cerebral artery: a case report

Öz:

Vertigo ve senkop nöbetleri geçiren ve aynı tarafta servikal internal karotis arter (İKA) darlığı olan 85 yaşında bir erkek persistan primitif hipoglossal arter (PPHA) olgusu sunuldu. Embolik koruma cihazları olmaksızın karotis arter stentleme (KAS) işlemi yapıldı. Hastanın ameliyat sonrası klinik seyri iyiydi. Ameliyat sonrası manyetik rezonans görüntülemede iskemik komplikasyon izlenmedi. Ameliyatın beşinci gününde, nörolojik semptomu olmayan hasta taburcu edildi. Bilgimiz dahilinde bu olgu, literatürdeki KAS ile tedavi edilen ve ipsilateral karotis-baziler anastomozlu ikinci İKA darlığı olgusudur. Persistan karotis-vertebrobaziler anastomozları çok nadir görülmekle birlikte, nörolojik defisitlere ve hatta ölüme yol açan iyatrojenik hasarı önlemek için iyatrojenik girişimsel radyologlar, vasküler ve kardiyovasküler cerrahlar ve nöroşirürji uzmanlarının bu nadir varyasyonun varlığını göz önünde bulundurması gereklidir. Nörovasküler patolojilerin tedavisinde tedavi seçeneklerini etkileyebilen veya işlem tekniğini değiştirebilen varyasyon ve anomaliler de göz önünde bulundurulmalıdır.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi Cerrahi

İpsilateral persistan primitif hipoglossal arter ve ön serebral arterin A1 segmentinde aplazi ile birliktelik gösteren ciddi internal karotis arter darlığının karotis arteriyel stentleme ile başarılı tedavisi: Olgu sunumu

Öz:

We report a 85-year-old male case with persistent primitive hypoglossal artery (PPHA) who experienced vertigo and syncope attacks and had cervical internal carotid artery (ICA) stenosis at the same side. A carotid artery stenting (CAS) procedure was performed without embolic protection devices. The patient’s postoperative clinical course was good. Postoperative magnetic resonance imaging showed no ischemic complications. On fifth day of surgery, the patient was discharged with no neurological symptoms. We report, to the best of our knowledge, the second case of ICA stenosis with ipsilateral carotid-basilar anastomosis treated with CAS presented in the literature. Although persistent carotidvertebrobasilar anastomoses are very rare; awareness of the presence of this rare variation is essential for interventional radiologists, vascular and cardiovascular surgeons and neurosurgeons to avoid iatrogenic injury causing neurologic deficits, and even death. For the treatment of neurovascular pathologies, variations and anomalies which can affect treatment options or modify the procedural technique should be also considered.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi Cerrahi

Belge Türü: Makale Makale Türü: Olgu Sunumu Erişim Türü: Erişime Açık

1) Hatayama T, Yamane K, Shima T, Okada Y, Nishida M. Persistent primitive hypoglossal artery associated with cerebral aneurysm and cervical internal carotid artery stenosis--case report. Neurol Med Chir (Tokyo) 1999;39:372-5.
2) Katoh M, Kamiyama H, Kobayashi N, Makino K, Takano K, Tokumitsu N, et al. Severe stenosis of the internal carotid artery presenting as loss of consciousness due to the presence of a primitive hypoglossal artery: a case report. Surg Neurol 1999;51:310-2.
3) Vlychou M, Georganas M, Spanomichos G, Kanavaros P, Artinopoulos C, Zavras GM. Angiographic findings and clinical implications of persistent primitive hypoglossal artery. BMC Med Imaging 2003;3:2.
4) Pyun HW, Lee DH, Kwon SU, Lee JH, Choi CG, Kim SJ, Suh DC. Internal carotid artery stenosis with ipsilateral persistent hypoglossal artery presenting as a multiterritorial embolic infarction: a case report. Acta Radiol 2007;48:116-8.
5) Conforto AB, de Souza M, Puglia P Jr, Yamamoto FI, da Costa Leite C, Scaff M. Bilateral occipital infarcts associated with carotid atherosclerosis and a persistent hypoglossal artery. Clin Neurol Neurosurg 2007;109:364-7.
6) McCartney SF, Ricci MA, Labreque P, Symes JF. Persistent hypoglossal artery encountered during carotid endarterectomy. Ann Vasc Surg 1989;3:257-60.
7) Sunada I, Yamamoto S, Matsuoka Y, Nishimura S. Endarterectomy for persistent primitive hypoglossal artery-- case report. Neurol Med Chir (Tokyo) 1991;31:104-8.
8) Fantini GA, Reilly LM, Stoney RJ. Persistent hypoglossal artery: diagnostic and therapeutic considerations concerning carotid thromboendarterectomy. J Vasc Surg 1994 ;20:995-9.
9) Megyesi JF, Findlay JM, Sherlock RA. Carotid endarterectomy in the presence of a persistent hypoglossal artery: case report. Neurosurgery 1997;41:669-72.
10) Kanazawa R, Ishihara S, Okawara M, Ishihara H, Kohyama S, Yamane F. A successful treatment with carotid arterial stenting for symptomatic internal carotid artery severe stenosis with ipsilateral persistent primitive hypoglossal artery: case report and review of the literature. Minim Invasive Neurosurg 2008;51:298-302. doi: 10.1055/s-0028- 1082299.
11) Komiyama M, Nakajima H, Nishikawa M, Yasui T, Kitano S, Sakamoto H, et al. High incidence of persistent primitive arteries in moyamoya and quasi-moyamoya diseases. Neurol Med Chir (Tokyo) 1999;39:416-20.

APA	NUMAN F, GÜLŞEN F, YILMAZ O, CANTAŞDEMİR M, SOLAK S, SÖNMEZ B (2013). A successful treatment with carotid arterial stenting for symptomatic severe internal carotid artery stenosis with ipsilateral persistent primitive hypoglossal artery and aplasia of the A1 segment of anterior cerebral artery: a case report. , 440 - 444.
Chicago	NUMAN Fürüzan,GÜLŞEN Fatih,YILMAZ OĞUZ,CANTAŞDEMİR MURAT,SOLAK SERDAR,SÖNMEZ Bingür A successful treatment with carotid arterial stenting for symptomatic severe internal carotid artery stenosis with ipsilateral persistent primitive hypoglossal artery and aplasia of the A1 segment of anterior cerebral artery: a case report. (2013): 440 - 444.
MLA	NUMAN Fürüzan,GÜLŞEN Fatih,YILMAZ OĞUZ,CANTAŞDEMİR MURAT,SOLAK SERDAR,SÖNMEZ Bingür A successful treatment with carotid arterial stenting for symptomatic severe internal carotid artery stenosis with ipsilateral persistent primitive hypoglossal artery and aplasia of the A1 segment of anterior cerebral artery: a case report. , 2013, ss.440 - 444.
AMA	NUMAN F,GÜLŞEN F,YILMAZ O,CANTAŞDEMİR M,SOLAK S,SÖNMEZ B A successful treatment with carotid arterial stenting for symptomatic severe internal carotid artery stenosis with ipsilateral persistent primitive hypoglossal artery and aplasia of the A1 segment of anterior cerebral artery: a case report. . 2013; 440 - 444.
Vancouver	NUMAN F,GÜLŞEN F,YILMAZ O,CANTAŞDEMİR M,SOLAK S,SÖNMEZ B A successful treatment with carotid arterial stenting for symptomatic severe internal carotid artery stenosis with ipsilateral persistent primitive hypoglossal artery and aplasia of the A1 segment of anterior cerebral artery: a case report. . 2013; 440 - 444.
IEEE	NUMAN F,GÜLŞEN F,YILMAZ O,CANTAŞDEMİR M,SOLAK S,SÖNMEZ B "A successful treatment with carotid arterial stenting for symptomatic severe internal carotid artery stenosis with ipsilateral persistent primitive hypoglossal artery and aplasia of the A1 segment of anterior cerebral artery: a case report." , ss.440 - 444, 2013.
ISNAD	NUMAN, Fürüzan vd. "A successful treatment with carotid arterial stenting for symptomatic severe internal carotid artery stenosis with ipsilateral persistent primitive hypoglossal artery and aplasia of the A1 segment of anterior cerebral artery: a case report". (2013), 440-444.

APA	NUMAN F, GÜLŞEN F, YILMAZ O, CANTAŞDEMİR M, SOLAK S, SÖNMEZ B (2013). A successful treatment with carotid arterial stenting for symptomatic severe internal carotid artery stenosis with ipsilateral persistent primitive hypoglossal artery and aplasia of the A1 segment of anterior cerebral artery: a case report. Türk Göğüs Kalp Damar Cerrahisi Dergisi, 21(2), 440 - 444.
Chicago	NUMAN Fürüzan,GÜLŞEN Fatih,YILMAZ OĞUZ,CANTAŞDEMİR MURAT,SOLAK SERDAR,SÖNMEZ Bingür A successful treatment with carotid arterial stenting for symptomatic severe internal carotid artery stenosis with ipsilateral persistent primitive hypoglossal artery and aplasia of the A1 segment of anterior cerebral artery: a case report. Türk Göğüs Kalp Damar Cerrahisi Dergisi 21, no.2 (2013): 440 - 444.
MLA	NUMAN Fürüzan,GÜLŞEN Fatih,YILMAZ OĞUZ,CANTAŞDEMİR MURAT,SOLAK SERDAR,SÖNMEZ Bingür A successful treatment with carotid arterial stenting for symptomatic severe internal carotid artery stenosis with ipsilateral persistent primitive hypoglossal artery and aplasia of the A1 segment of anterior cerebral artery: a case report. Türk Göğüs Kalp Damar Cerrahisi Dergisi, vol.21, no.2, 2013, ss.440 - 444.
AMA	NUMAN F,GÜLŞEN F,YILMAZ O,CANTAŞDEMİR M,SOLAK S,SÖNMEZ B A successful treatment with carotid arterial stenting for symptomatic severe internal carotid artery stenosis with ipsilateral persistent primitive hypoglossal artery and aplasia of the A1 segment of anterior cerebral artery: a case report. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2013; 21(2): 440 - 444.
Vancouver	NUMAN F,GÜLŞEN F,YILMAZ O,CANTAŞDEMİR M,SOLAK S,SÖNMEZ B A successful treatment with carotid arterial stenting for symptomatic severe internal carotid artery stenosis with ipsilateral persistent primitive hypoglossal artery and aplasia of the A1 segment of anterior cerebral artery: a case report. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2013; 21(2): 440 - 444.
IEEE	NUMAN F,GÜLŞEN F,YILMAZ O,CANTAŞDEMİR M,SOLAK S,SÖNMEZ B "A successful treatment with carotid arterial stenting for symptomatic severe internal carotid artery stenosis with ipsilateral persistent primitive hypoglossal artery and aplasia of the A1 segment of anterior cerebral artery: a case report." Türk Göğüs Kalp Damar Cerrahisi Dergisi, 21, ss.440 - 444, 2013.
ISNAD	NUMAN, Fürüzan vd. "A successful treatment with carotid arterial stenting for symptomatic severe internal carotid artery stenosis with ipsilateral persistent primitive hypoglossal artery and aplasia of the A1 segment of anterior cerebral artery: a case report". Türk Göğüs Kalp Damar Cerrahisi Dergisi 21/2 (2013), 440-444.