Bilateral common carotid artery occlusion — A case report and literature review

Lai, Shung-Lon; Chen, Yi‐Chun; Weng, Hsu–Huei; Chen, Sien-Tsong; Hsu, Shih‐Pin; Lee, Tsong‐Hai

doi:10.1016/j.jns.2005.06.012

Cited by 27 publications

(25 citation statements)

References 22 publications

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“…First, gradual narrowing of CCAs partly simulates consequences of atheromatous plaques that gradually enlarge in the carotid arteries. Second, ischemic infarcts were induced after the AC implantation as often observed in human carotid artery occlusive disease [3], [4]. Compared to the rats or other mouse strains, the C57BL/6 mice have less developed PcomA and are thought to be the most susceptible to cerebral ischemia following bilateral common carotid occlusion/stenosis [7].…”

Section: Discussionmentioning

confidence: 99%

“…They are susceptible to cerebral ischemia such as cerebral infarction [1] and cognitive impairment [2]. Patients with bilateral carotid artery occlusion have a particularly poor prognosis as a result of a high subsequent stroke prevalence rate (66% in bilateral internal carotid artery occlusion and 71% in bilateral common carotid artery occlusion [3]), and high mortality rate of more than 50% over six years [4]. Therefore, animal models which can mimic natural history of severe carotid artery disease are warranted to develop novel and safer prophylactic medications to protect patients at risk from cerebral ischemia distal to severe carotid artery diseases.…”

Section: Introductionmentioning

confidence: 99%

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A Novel Mouse Model of Ischemic Carotid Artery Disease

et al. 2014

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BackgroundCarotid artery occlusive disease gradually develops over time, eventually leading to cerebral infarction and high mortality rate. Animal models replicating cerebral infarction resulting from carotid artery occlusive disease have thus been developed to test potential novel treatments, which could be subsequently administered clinically.MethodsAdult C57BL/6J male mice were subjected to ameroid constrictor (AC) placement to gradually narrow the bilateral common carotid arteries. Cerebral blood flow (CBF) was measured at several time points. At 7 and 28 days post-operation, post-mortem brain samples were analyzed for ischemic changes.ResultsThe mortality rate was 58.8% at 28 days post-operation. Surviving mice with AC showed continuous reduction of CBF by up to 70% of the baseline level at 28 days. Most of the mice (75%) showed multiple cerebral infarctions in the gray and white matter. Non-surviving mice showed critical CBF reduction below 20–30% of the baseline level before death.ConclusionThe application of the AC on the bilateral common carotid arteries in mice could offer a reliable model of severe cerebrovascular insufficiency due to carotid artery occlusive disease and may thus be useful in exploring pharmacological intervention in stroke through monitoring survival rate, infarct formation, and CBF profile.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Novel Mouse Model of Ischemic Carotid Artery Disease

et al. 2014

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“…the basilar terminus (BT). [12][13][14][15] However, anterior de novo aneurysms have been reported to follow bilateral ICA occlusion, 16 presumably as a result of hemodynamic forces due to flow rerouting into the external carotid arteries and their anastomotic intracranial branches including the ophthalmic artery (OA). Such aneurysm presentation has also mirrored anterior de novo IAs observed in Moyamoya disease, 17 which involves progressive bilateral carotid occlusion.…”

Section: Introductionmentioning

confidence: 99%

Aneurysmal Remodeling in the Circle of Willis after Carotid Occlusion in an Experimental Model

Tutino

Mandelbaum

Choi³

et al. 2013

J Cereb Blood Flow Metab

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Carotid occlusions are associated with de novo intracranial aneurysm formation in clinical case reports, but this phenomenon is not widely studied. We performed bilateral carotid ligation (n ¼ 9) in rabbits to simulate carotid occlusion, and sham surgery (n ¼ 3) for control. Upon euthanasia (n ¼ 3 at 5 days, n ¼ 6 at 6 months post ligation, and n ¼ 3 at 5 days after sham operation), vascular corrosion casts of the circle of Willis (CoW) were created. Using scanning electron microscopy, we quantified gross morphologic, macroscopic, and microscopic changes on the endocasts and compared findings with histologic data. At 5 days, CoW arteries of ligated animals increased caliber. The posterior communicating artery (PCom) increased length and tortuosity, and the ophthalmic artery (OA) origin presented preaneurysmal bulges. At 6 months, calibers were unchanged from 5 days, PComs further increased tortuosity while presenting segmental dilations, and the OA origin and basilar terminus presented preaneurysmal bulges. This exploratory study provides evidence that flow increase after carotid occlusion produces both compensatory arterial augmentation and pathologic remodeling such as tortuosity and saccular/fusiform aneurysm. Our findings may have considerable clinical implications, as these lesser-known consequences should be considered when managing patients with carotid artery disease or choosing carotid ligation as a therapeutic option.

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“…The treatment of patients suffering from steno-occlusive disease of the brain feeding extracranial and intracranial vessels is complex [2][3][4] . Sometime an extracranial-intracranial bypass might be indicated in symptomatic patients, despite antiplatelet administration, presenting with reduced brain perfusion and haemodynamic impairment, in order to prevent clinical deterioration 1, 4 .…”

Section: Discussionmentioning

confidence: 99%

Bilateral flow changes after extracranial–intracranial bypass surgery in a complex setting of multiple brain-feeding arteries occlusion: The role of perfusion studies

Esposito

Pepa

Sabatino

et al. 2015

British Journal of Neurosurgery

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We report on a symptomatic case in which the whole intracranial blood supply was provided by a single vertebral artery as both internal carotid arteries were occluded and the contralateral vertebral artery was severely hypoplasic. The patient was treated by a flow-augmentation extracranial-intracranial bypass. Preoperative perfusion studies were essential in tailoring surgical strategy. Keypoints of the paper are contralateral perfusion changes after unilateral bypass surgery. The patient experienced a total recovery from symptoms and a bilateral improvement in brain perfusion, probably as consequence of post-operative hemodynamic rearrangement. Originally published at: Esposito, Giuseppe; Della Pepa, Giuseppe Maria; Sabatino, Giovanni; Gaudino, Simona; Puca, Alfredo; Maira, Giulio; Marchese, Enrico; Albanese, Alessio (2015). Bilateral flow changes after extracranialintracranial bypass surgery in a complex setting of multiple brain-feeding arteries occlusion: The role of perfusion studies. British Journal of Neurosurgery, 29 (5) Disclosure statement: the authors declare no interest to disclose, they have any personal or institutional financial interest in drugs, materials, or devices described in this submission and that they did not receive any specific funding. The paper and any of its contents have been presented previously. AbstractWe report on a symptomatic case in which the whole intracranial blood supply was provided by a single vertebral artery as both carotid were occluded and the contralateral vertebral artery was severely hypoplasic. The patient was treated by a flow-augmentation extra-intracranial bypass.Preoperative perfusion studies were essential in tailoring surgical strategy. Keypoint of the paper are contralateral perfusion changes after unilateral bypass surgery. The patient experienced a total recover from symptoms and a bilateral improvement in brain perfusion, probably as consequence of post-operative haemodynamic rearrangement.

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Bilateral common carotid artery occlusion — A case report and literature review

Cited by 27 publications

References 22 publications

A Novel Mouse Model of Ischemic Carotid Artery Disease

A Novel Mouse Model of Ischemic Carotid Artery Disease

Aneurysmal Remodeling in the Circle of Willis after Carotid Occlusion in an Experimental Model

Bilateral flow changes after extracranial–intracranial bypass surgery in a complex setting of multiple brain-feeding arteries occlusion: The role of perfusion studies

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