Carotid artery stenting with persistent primitive hypoglossal artery performed by carotid direct puncture and double distal filter protection: a case report

Ebiko, Yusuke; Yoshino, Yoshikazu; Ikota, Masashi; Watabe, Takeya; Uchiyama, Taku; Soma, Natsumi; Kusaka, Gen

doi:10.3995/jstroke.10898

Cited by 1 publication

(5 citation statements)

References 18 publications

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Section: Discussionmentioning

confidence: 99%

“…[ 13 ] and Ebiko et al . [ 1 ] performed CAS without ischemic complications by implanting a DF type EPD in both the ICA and PPHA. The problem with this technique is that since the EPD is not coaxial with the stent, it might get stuck in between the stent and the vessel wall, making its retrieval difficult.…”

Section: Discussionmentioning

confidence: 99%

“…ere are 12 reported cases of CAS for ICA stenosis accompanied by PPHA, including ours. [1,2,[5][6][7][8]10,[12][13][14]18] However, in each case, the site of stenosis was different, as was the treatment method [Table 1]. When CAS is performed, proximal protection using a balloon guide catheter (BGC) has been used in several cases due to concerns about the dispersal of the plaque from the site of stenosis.…”

Section: Discussionmentioning

confidence: 99%

“…Distal filter (DF) type EPDs can be used to maintain intracranial blood flow, and there have been reports of DF type EPDs being used in patients with ICA stenosis and PPHA. [1,13,14] Silva et al [13] and Ebiko et al [1] performed CAS without ischemic complications by implanting a DF type EPD in both the ICA and PPHA. e problem with this technique is that since the EPD is not coaxial with the stent, it might get stuck in between the stent and the vessel wall, making its retrieval difficult.…”

Section: Discussionmentioning

confidence: 99%

“…ere are only four previously reported cases of stent placement for ICA stenosis associated with PPHA. [1,2,[5][6][7][8]10,[12][13][14]18] We report a strategy using a CASPER stent and Spider FX and compare it with the methods described in the previous reports.…”

Section: Introductionmentioning

confidence: 99%

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Strategy of cerebral endovascular treatment for cervical internal carotid artery stenosis with a persistent primitive hypoglossal artery

Yoshida,

Kamatani,

Takigawa

et al. 2023

Surgical Neurology International

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Background: Persistent primitive hypoglossal artery (PPHA) is a rare residual arterial anastomosis. We placed a CASPER stent using Spider FX as an embolic protection device (EPD) in a patient with internal carotid artery (ICA) stenosis and PPHA. There are no reports of carotid artery stenting (CAS) using a CASPER stent for ICA stenosis with PPHA. We report the EPD strategy used in this case and the usefulness and precautions of CASPER stent insertion for cervical ICA stenosis in association with PPHA. Methods: A 9Fr sheath was placed in the right femoral artery and a 9Fr Branchor balloon guide catheter was guided to the common carotid artery. A Spider FX was placed proximal to the bifurcation of the ICA and the PPHA. A 10 mm × 20 mm CASPER stent was deployed at the site of the stricture with no postoperative ischemic complications. Results: There was no intra-stent occlusion, stenosis, or plaque protrusion immediately after surgery, and no postoperative ischemic complications were observed. Conclusion: CASPER stent deployment with the Spider FX in the ICA and PPHA bifurcation can be considered to be an effective treatment method for ICA stenosis associated with PPHA. However, care should be taken in selecting the appropriate EPDs and stents depending on the location of the stenosis and bifurcation of the PPHA.

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