Bilateral internal carotid artery agenesis is a very rare congenital anomaly, which may be accompanied by various types of associated vascular abnormalities, included intracranial aneurysms or dolichoectatic change of posterior circulation. In this article, we present unique, and to the best of our knowledge, the first case of bilateral internal carotid agenesis associated with basilar artery fenestration, which resembles intra-arterial floating thrombus.

Transcatheter arterial embolization (TAE) has been known as effective method to treat nontraumatic gastrointestinal hemorrhage. But there were only a few case reports of TAE in patients with traumatic mesenteric hemorrhage. Herein we report a case of mesenteric bleeding following blunt abdominal trauma successfully treated solely with TAE. A 64-year-old man with blunt abdominal trauma caused in a motorcycle accident was presented emergency department via other hospital. He was hemodynamically unstable on admission. After rapid fluid resuscitation, an abdominal computed tomography (CT) with contrast enhancement was performed and it showed a large amount of hemoperitoneum without definite extravasation of contrast media. But there was mesenteric contusion with very small area of contrast media Extravasation of contrast media from ileocolic artery of superior mesenteric artery (SMA) was observed on SMA angiography. TAE was performed using coil and gelfoam. After TAE, the blood supply of the distal portion was still preservedvia collateral circulation. His hemodynamics stabilized after TAE. He was discharged on 24 th day after TAE without any complication. We think TAE may be an alternative to emergency laparotomy in isolated mesenteric injury.