Surgical strategy to minimize ischemia during trapping/resection of giant extracranial carotid artery aneurysm stratified by collateral evaluation

Hongo, Hiroki; Inoue, Tomohiro; Tamura, Akira; Saito, Isamu

doi:10.4103/2152-7806.200576

Cited by 2 publications

(1 citation statement)

References 10 publications

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“…In contrast to BTO, the manual carotid compression test is an easy and accustomed maneuver. This test frequently uses to verify collateral circulation from circle of Willis, such as Allcock's test5)6) for evaluating posterior communicating artery. The test as we did is not so different from such method that many clinicians usually do during cerebral angiography.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of External Carotid Artery Angiogram with Manual Carotid Compression in Ophthalmic Artery Aneurysm

Jin¹,

Kwak²,

Kim³

et al. 1970

J Cerebrovasc Endovasc Neurosurg

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ObjectiveIdentifying collaterals from external carotid artery (ECA) is necessary before treatment of ophthalmic artery (OphA) aneurysm. We present a manual carotid compression test to verify collaterals in ophthalmic artery aneurysms, and evaluate its usefulness.Materials and MethodsFrom March 2013 to December 2017, endovascular coiling was performed 19 consecutive patients with 20 OphA aneurysms. We performed manual carotid compression test for patients who had aneurysms incorporating entry of OphA. Clinical and angiographic outcomes were investigated.ResultsOf 13 cases underwent manual carotid compression test, 12 cases were confirmed collateral flow from ECA to OphA. During the coil embolization, we tried to maintain the original OphA flow even if it has a collateral anastomosis. Among them, OphA occlusion occurred in one patient during coiling. Recurrence of aneurysm was occurred in a ruptured case and additional embolization was required.ConclusionsThe manual carotid compression test is useful method to identify the collaterals from ECA in patients with OphA aneurysm. This test can be used as a screening test for confirming collateral flow in OphA aneurysms or as an alternative for patients who are difficult to perform BTO.

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Section: Discussionmentioning

confidence: 99%

Usefulness of External Carotid Artery Angiogram with Manual Carotid Compression in Ophthalmic Artery Aneurysm

Jin¹,

Kwak²,

Kim³

et al. 1970

J Cerebrovasc Endovasc Neurosurg

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show abstract

High-flow bypass with radial artery graft followed by internal carotid artery ligation for large or giant aneurysms of cavernous or cervical portion: clinical results and cognitive performance

Ono¹,

Inoue

Tanishima³

et al. 2017

Neurosurg Rev

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High-flow bypass followed by ligation of the internal carotid artery (ICA) is an effective treatment, but the impact of abrupt occlusion of the ICA is unpredictable, especially on postoperative cognitive function. The present study evaluated the clinical results as well as cognitive performances after high-flow bypass using radial artery graft (RAG) with supportive superficial temporal artery (STA)-middle cerebral artery (MCA) bypass, followed by ICA ligation. Ten consecutive patients underwent high-flow bypass surgery for large or giant ICA aneurysms of cavernous or cervical portion. Demographics, clinical information, magnetic resonance (MR) imaging, computed tomography, digital subtraction angiography (DSA), intraoperative somatosensory evoked potentials, neuropsychological examinations including the Wechsler Adult Intelligence Scale-Third Edition and the Wechsler Memory Scale-Revised (WMS-R), and follow-up data were analyzed. The aneurysm was located on the cavernous segment in eight cases and cervical segment in two cases, and mean aneurysm size was 27.9 mm. Postoperative DSA demonstrated robust bypass flow from the external carotid artery to MCA via the RAG, and no anterograde flow into the aneurysm. No patient showed new symptoms after the operation. Follow-up clinical study and MR imaging were performed in nine patients and showed no additional ischemic lesion compared with preoperative imaging. Seven patients completed neuropsychological examinations before and after surgery. All postoperative scores except WMS-R composite memory score slightly improved. High-flow bypass followed by ICA ligation can achieve good clinical outcomes. Successful high-flow bypass using RAG with supportive STA-MCA bypass and ICA ligation does not adversely affect postoperative cognitive function.

show abstract

Surgical strategy to minimize ischemia during trapping/resection of giant extracranial carotid artery aneurysm stratified by collateral evaluation

Cited by 2 publications

References 10 publications

Usefulness of External Carotid Artery Angiogram with Manual Carotid Compression in Ophthalmic Artery Aneurysm

Usefulness of External Carotid Artery Angiogram with Manual Carotid Compression in Ophthalmic Artery Aneurysm

High-flow bypass with radial artery graft followed by internal carotid artery ligation for large or giant aneurysms of cavernous or cervical portion: clinical results and cognitive performance

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