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Eur Stroke J 2017 Dec 10;2(4):335-345. Epub 2017 Jul 10.

Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.

Introduction: Cervical artery dissections may be preceded by mechanical trigger events, often related to sports.

Methods: Using the MEDLINE database, we identified case reports and case series of sports-related cervical artery dissections. Information of the type of sport, age and gender of the patient, affected vessels, associated infarction, time delay, and neurological sequelae were extracted. Read More

World Neurosurg 2019 Apr 14. Epub 2019 Apr 14.

Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan.

Background: In clipping surgery, it is advantageous to dissect an adhered artery from the aneurysmal dome to achieve complete clipping. Bypass surgery is useful to reconstruct an adhered artery when dissection of the artery is technically difficult or risky. Here, we report the effectiveness of tailor-made intracranial (IC)-IC bypass to reconstruct an adhered artery in clipping surgery for middle cerebral artery (MCA) aneurysms. Read More

Neurosurgery 2019 Apr 17. Epub 2019 Apr 17.

Department of Cardiovascular Surgery, Texas Medical Center, Houston, Texas.

Background: Despite advances in robotic-assisted technology for cardiac and peripheral vascular interventions, a robotic-assisted platform for neurovascular intervention is not yet available.

Objective: To evaluate the feasibility of the CorPath® GRX robotic-assisted platform (Corindus Inc, Waltham, Massachusetts) for neurovascular interventions through preclinical study.

Methods: The robotic system was tested for its ability to accurately navigate a variety of common neurovascular devices in an in Vitro flow model and in a live, anesthetized pig, under conditions and following procedures appropriate for clinical intervention. Read More

Circulation 2019 Apr;139(16):1977-1978

Division of Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia (M.K., P.V., W.Y.S., J.E.B., N.D.D.).

J Vis Exp 2019 Mar 30(145). Epub 2019 Mar 30.

Neuroscience and Mental Health Institute, University of Alberta; Sensory Motor Adaptive Rehabilitation Technology (SMART) Network, University of Alberta; Division of Physical Medicine and Rehabilitation, University of Alberta.

The video describes in detail the catheterization of the distal brachial artery in swine. This technique enables researchers to measure arterial blood pressure continuously and collect arterial blood samples to assess arterial blood gas measurements. Arterial blood pressures and arterial blood gases are important physiological parameters to monitor during experimental procedures. Read More

Catheter Cardiovasc Interv 2019 Apr 15. Epub 2019 Apr 15.

Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia.

Objectives: To assess the commonly reported complications and failure modes for FilterWire EZ Embolic Protection Devices (EPD) by analyzing the postmarketing surveillance data from the Food and Drug Administration (FDA) Manufacturer and User Facility Device Experience (MAUDE) database.

Background: EPDs prevent distal embolization of atheroembolic materials during percutaneous interventions resulting in reduced microvascular obstruction and improved microcirculation while maintaining tissue perfusion. The FilterWire EZ EPD (Boston Scientific, Natick, MA) is approved for use in interventions of de novo saphenous vein grafts (SVG) and carotid artery stenosis. Read More

J Stroke Cerebrovasc Dis 2019 Apr 10. Epub 2019 Apr 10.

Department of Neurosurgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.

Background And Purpose: During mechanical thrombectomy for acute main trunk occlusion, we sometimes encounter difficult situation; 1 M2 branch of the middle cerebral artery is successfully recanalized, while the other remains occluded. In this study, we focused on the angiographical findings of remnant occlusion.

Methods: Among 83 patients who underwent mechanical thrombectomy for the acute internal carotid artery or proximal middle cerebral artery (M1) occlusion, 25 patients (30%) intraoperatively exhibited the remnant M2 occlusion, in spite of the recanalization of the other M2. Read More

Neurol Sci 2019 Apr 12. Epub 2019 Apr 12.

Department of Medicine, Maggiore Hospital, Bologna, BO, Italy.

Antiplatelet agents and vitamin K antagonists (VKA) are usually used in the treatment of cervical (carotid or vertebral) artery dissections (CADs); however, data about the use of direct oral anticoagulants (DOACs) in these conditions are very limited. DOACs have proven to be effective in stroke reduction in non-valvular atrial fibrillation and, when possible, they are preferred to warfarin because of their better safety profile. We describe four cases of CADs and, firstly in literature, cervico-cerebral (CCADs) in young patients (average age of 42 years) treated with rivaroxaban 20 mg daily. Read More

Clin Imaging 2019 Mar 30;56:73-76. Epub 2019 Mar 30.

Department of Diagnostic Radiology, Michigan Medicine, 1500 E Medical Center Dr, Ann Arbor, MI 48109, USA.

Retropharyngeal carotid arteries are a common clinically relevant anatomic variant. "Peripatetic" carotid arteries refer to change in position to and from a retropharyngeal location, and are a newly described finding. Knowledge of this phenomenon is important to avoid potential procedural complications as well as misdiagnosis. Read More

Rom J Intern Med 2019 Mar;57(1):69-71

Department of Cardiology and Physiology, Universitary Hospital, Universidad Abierta Interamericana,Faculty of Medicine, Buenos Aires, Argentine.

There are few case reports of cases of carotid and aortic dissection related to the ergotamine abuse, but the cases that affect the coronary arteries is a very rare coronary. We present a patient of a 48-year-old female with an ST-segment elevation myocardial infarction attributable to chronic ergotamine use. The coronary angiography showed dissection of right coronary artery proximal. Read More

J Neurointerv Surg 2019 Apr 6. Epub 2019 Apr 6.

Interventional Neuroradiology Service, Department of Radiology, Beaumont Hospital, Dublin, Ireland.

Background: Mechanical thrombectomy is the standard of care for acute ischemic strokes with proximal intracranial occlusion. Arterial access is commonly achieved with femoral artery puncture, although this is not always possible. In this case series, we describe 11 cases of anterior circulation stroke where direct carotid puncture was used to obtain vascular access. Read More

Surg Radiol Anat 2019 Apr 3. Epub 2019 Apr 3.

Anatomy, University Paris Diderot, 75010, Paris, France.

Purpose: Although the morphology of the parapharyngeal adipose corpus (PAC) has been already described, the clinical interest of its volume and weight in the genesis of obstructive sleep apnea syndrome (OSAS) is still controversial. The volume of the PAC has been determined in OSAS patients but not in a normal population. The aim of our study was to investigate the morphology of the PAC by dissection and MRI in a normal population and to determine if there is a relation between the dimensions and volume of the PAC and the Body Mass Index (BMI). Read More

Surg Radiol Anat 2019 Apr 1. Epub 2019 Apr 1.

Department of Orthopaedic Surgery and Musculoskeletal Medicine (MSM), University of Otago, Christchurch School of Medicine, 2 Riccarton Avenue, Christchurch, 8011, New Zealand.

Purpose: To describe the origin of the vessels supplying the anterior sub-axial cervical vertebrae (C3-C7) to further understand their potential influence on anterior bone loss after anterior cervical spinal surgery.

Method: Cadaveric dissection was performed on ten adult human necks after latex perfusion of their subclavian, common carotid and vertebral arteries. The nutrient vessels of the sub-axial cervical spine were identified and traced to their origin. Read More

Radiol Case Rep 2019 Jun 20;14(6):647-651. Epub 2019 Mar 20.

Mater Misericordiae University Hospital, Dublin, Ireland.

Common carotid artery dissection is an unusual clinical event that most commonly occurs secondary to type A aortic dissection. We present a rare case of spontaneous common carotid artery dissection temporally preceding aortic dissection. Our case highlights the careful attention that cases of common carotid dissection should be given; our knowledge base regarding their natural history and evidence-based management is distinctly lacking compared to dissection of other cervical vessels. Read More

J Vasc Surg 2019 Mar 25. Epub 2019 Mar 25.

Department of Thoracic and Vascular Surgery, Arnaud de Villeneuve Hospital, Montpellier, France.

Objective: The aim of this retrospective analysis was to evaluate the outcomes of physician-modified double fenestrated stent grafts for total endovascular aortic arch repair: one proximal large fenestration for the brachiocephalic trunk and the left common carotid artery and one distal fenestration for the left subclavian artery (LSA).

Methods: From January 2017 through February 2018, 17 patients (88.2% elective) underwent thoracic endovascular aortic repair (TEVAR) with double homemade fenestrated stent graft for total endovascular aortic arch repair to maintain supra-aortic trunk patency. Read More

J Thorac Cardiovasc Surg 2019 Feb 21. Epub 2019 Feb 21.

Cardiovascular Clinic Bad Neustadt, Bad Neustadt, Germany.

Objectives: The aim of the study was to evaluate the surgical and neurological outcomes after aortic arch surgery using unilateral cerebral perfusion.

Methods: Between June 2004 and February 2017, a total of 1000 patients (mean age 63 ± 12; range, 14-88 years) with nonacutely dissected aortic pathology (aneurysm, porcelain aorta, chronic dissection, infection, and injury in 89.1%, 4. Read More

Oper Neurosurg (Hagerstown) 2019 Mar 28. Epub 2019 Mar 28.

Department of Neurological Surgery, Mayo Clinic, Phoenix, Arizona.

Cognard type V dural fistulas represent a rare and unique entity, and present clinically with myelopathy. They are frequently located around the foramen magnum and are most commonly fed by dural branches of the vertebral and external carotid artery. Detection requires meticulous angiography to define the angioarchitecture of the fistula, which in turn defines the treatment modality. Read More

J Biomed Mater Res A 2019 Mar 27. Epub 2019 Mar 27.

Department of Pediatric Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

To evaluate the properties and efficacy of a novel braided biodegradable stent (BBS) consisting of poly (p-dioxanone) (PPDO) and polycaprolactone (PCL) for usage in children with congenital cardiovascular diseases. PCL/PPDO composite filaments were fabricated by coating PCL layers onto PPDO filaments, which were fused with PPDO monofilaments to form the BBS. Physical properties of BBSs including elastic recovery rate, deformation rate, and mechanical characteristics with adjunctive post-dilation were evaluated by radial force-tests. Read More

Neurohospitalist 2019 Apr 4;9(2):105-108. Epub 2018 Sep 4.

Division of Stroke and Vascular Neurology, Mercy Health Hauenstein Neurosciences, Grand Rapids, MI, USA.

Eagle syndrome is a rare cause of stroke and results as a complication of the elongated styloid process (ESP), which can cause carotid dissection and consequent ischemic stroke. We report a case of a 42-year-old woman with a past medical history of rheumatoid arthritis who developed left hemispheric ischemic stroke after deep tissue massage. Imaging studies revealed an intimal tear of the left carotid artery bulb and bilaterally ESPs, measuring approximately 6 cm on the right and 4. Read More

Front Neurol 2019 11;10:206. Epub 2019 Mar 11.

Department of Diagnostic and Therapeutic Neuroradiology, University Hospital of Nancy, Nancy, France.

Endovascular therapy has been shown to be an effective and safe treatment for tandem occlusion. The endovascular therapeutic strategies for tandem occlusions strokes have not been adequately evaluated and the best approach is still controversial. The TITAN (Thrombectomy in TANdem occlusions) registry was a result of a collaborative effort to identify the best therapeutic approach for acute ischemic stroke due to tandem lesion. Read More

J Neurol Surg A Cent Eur Neurosurg 2019 May 26;80(3):205-212. Epub 2019 Mar 26.

Institute of Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.

Background:  In spite of the advent of neurointerventional treatment, different clinical and anatomical features are still strong indications for clipping of posterior communicating artery (PComA) aneurysms. But the experience of young neurosurgeons is increasingly limited, and therefore providing technical operative guidelines is a fundamental prerequisite to achieve the best aneurysm exclusion and avoid perioperative complications.

Study Objective:  We describe a technical algorithm we use to teach young neurosurgeons how to approach carotid aneurysms that may help them develop a procedural memory and thus perform an efficient and safe surgery. Read More

J Chin Med Assoc 2019 Mar;82(3):209-214

Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.

Background: DeBakey type I aortic dissection is a catastrophic event that presents a formidable challenge to cardiovascular surgeon. Here, we evaluate a new combined surgical and endovascular technique for acute condition.

Methods: Between December 2011 and December 2015, 12 patients with type I aortic dissection concomitant involving supra-aortic vessels underwent ascending aortic replacement and simultaneous stent grafts inserted into the descending aorta, left subclavian, and left carotid arteries, and into the innominate artery when possible, without arch replacement. Read More

Neurosurg Rev 2019 Mar 22. Epub 2019 Mar 22.

Department of Neurosurgery, Virginia Commonwealth University, Richmond, VA, USA.

Extracranial internal carotid artery dissection (ICAD) is a potential source of morbidity and mortality in trauma patients and requires high degree of suspicion for diagnosis after the initial presentation. Occasionally, if standard therapy is contraindicated, endovascular reconstruction is a treatment option. The aim of this systematic review was to report clinical and radiographic outcomes following endovascular repair of ICAD of traumatic and iatrogenic etiology. Read More

Zh Vopr Neirokhir Im N N Burdenko 2019;83(1):29-39

Moscow Region Bureau of Forensic Medical Expertise, Moscow, Russia.

The anterior skull base structures are the site of initial growth of histologically different tumors. The difficulties in their removal are often associated with significant vascularization, which may limit the amount of resection due to abundant intraoperative blood loss. Midline tumors are primarily fed by the ethmoid arteries that are not accessible to embolization. Read More

Surg Radiol Anat 2019 Mar 21. Epub 2019 Mar 21.

Department of Radiology, Faculty of Medicine, Cairo University, Giza, Egypt.

Introduction: The ever expanding advances in various domains of cardiac and endovascular interventions has drawn tremendous attention toward the importance of the anatomical variability and morphometric parameters of the aortic arch (AA) and its branches.

Methods: The current study delineates the morphometry and anatomical variations of the AA branches by evaluating coronal, axial and sagittal CT multiplanar reformatted three-dimensional angiograms. Correlations between morphometric data as well as the distribution of morphometric data in relation to the anatomical variations were also illustrated. Read More

World Neurosurg 2019 Mar 18. Epub 2019 Mar 18.

Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA. Electronic address:

These video cases present some unique technical tenets for the microsurgical clipping of proximal internal carotid aneurysms. The first patient described in this case is a 49-year old female with a history of a prior ruptured and treated right MCA aneurysm who was found to have growth of known left MCA and left ICA ophthalmic segment aneurysms on radiographic studies. An intradural clinoidectomy with sonopet, proximal control at cervical carotid, wide sylvian fissure exposure with ample sharp dissection of the aneurysm anatomy allowed safe clipping of the ophthalmic aneurysm in this case. Read More

Neurol Sci 2019 Mar 20. Epub 2019 Mar 20.

Department of Neuroscience, Neurology and Stroke Unit, ASST GOM Niguarda Cà Granda Hospital, Piazza Ospedale Maggiore 3, 20162, Milan, Italy.

Headache is a milestone in cerebrovascular disorders; indeed, it may represent the only symptom at onset or predominates over the other neurological features. Unfortunately, headache associated with cerebrovascular diseases lacks clear-cut characteristics as it may resemble a migraine attack, tension-type headache, or cluster headache; pain localization is also misleading along with drug (analgesic) response. However, in this review, we have analyzed and described the most common patterns of headache for different vascular disorders: it is known that headache due to subarachnoid aneurysmal hemorrhage presents peculiar characteristics (thunderclap, acute presentation, and high intensity), whereas in cerebral vasoconstriction syndrome, the short duration and the relapsing-remitting course of the thunderclap headache are key points for the diagnosis; in cervicocerebral artery, dissection pain is most commonly ipsilateral to the dissected vessel and is mainly perceived in the temporal area in case of carotid artery dissection and in the occipital area in case of vertebral artery dissection; in cerebral venous thrombosis, pain is often acute or subacute and severe; unfortunately, it may resemble a typical migraine attack or a tension-type episode; by the contrary, in primary angiitis of the central nervous system, pain is always subacute or chronic with mild-to-moderate intensity; finally, in brain arteriovenous shunts such as malformation or fistula, pain is more frequently a clue for disease complication such as hemorrhage from the malformation or thrombosis of the draining vein. Read More

J Emerg Med 2019 Mar 16. Epub 2019 Mar 16.

McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, Texas.

Background: Studies cite the incidence of pediatric blunt cerebrovascular injuries (BCVI) ranges from 0.03% to 1.3%. Read More

Ann Med 2019 Mar 19:1-10. Epub 2019 Mar 19.

a Head and Neck Research Group, Research Centre, Akershus University Hospital , Oslo , Norway.

Cervical artery dissection refers to a tear in the internal carotid or the vertebral artery that results in an intramural haematoma and/or an aneurysmal dilatation. Although cervical artery dissection is thought to occur spontaneously, physical trauma to the neck, especially hyperextension and rotation, has been reported as a trigger. Headache and/or neck pain is the most common initial symptom of cervical artery dissection. Read More

Neurol Med Chir (Tokyo) 2019 Apr 16;59(4):154-161. Epub 2019 Mar 16.

Department of Neurosurgery, Tokyo Metropolitan Bokutoh Hospital.

Multi-vessel cervical arterial injury after blunt trauma is rare, and its pathophysiology is unclear. Although blunt cerebrovascular injury is a common cause of cerebral ischemia, its management is still controversial. We describe a 23-year-old man in previously good health who developed three-vessel cervical arterial dissections due to blunt trauma. Read More

Eur Ann Otorhinolaryngol Head Neck Dis 2019 Mar 11. Epub 2019 Mar 11.

ENT department, CHU Saint-Pierre, 322, rue Haute, 1000 Bruxelles, Belgium.

Introduction: Pulsatile tinnitus is a sound generated by an acoustic source from within the body, which is perceived by the auditory system of the patient.

Cases Summary: We report two puzzling cases of pulsatile tinnitus with normal ENT examinations: the first was due to a cervical internal carotid artery dissection, and the second to the compression of the foramina of Monro by a craniopharyngioma, leading to hydrocephalus.

Discussion: We review the systematic management and emphasize the decisive role of the ENT clinician regarding this pulsatile tinnitus complaint, because of the potentially severe complications of its underlying pathology. Read More

World J Clin Cases 2019 Mar;7(5):656-662

Department of Oral and Maxillofacial Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China.

Background: Paraganglioma/pheochromocytoma and medullary thyroid carcinoma can coexist and are often found in multiple endocrine neoplasia (MEN). However, very few cases highlight papillary thyroid carcinoma. We present herein a rare case of head and neck paraganglioma associated with papillary thyroid carcinoma. Read More

Autops Case Rep 2019 Jan-Mar;9(1):e2018054. Epub 2019 Jan 17.

Mount Sinai Medical Center, AM Rywlin MD Department of Pathology and Laboratory Medicine. Miami Beach, FL, United States of America.

Vascular Ehlers-Danlos Syndrome (VEDS) is a rare autosomal dominant disorder caused by mutations in the or genes. Its mortality is secondary to sudden and spontaneous rupture of arteries or hollow organs. The genotype influences the distribution of arterial pathology with aneurysms of intra-abdominal visceral arteries being relatively uncommon. Read More

Eplasty 2019 21;19:ic8. Epub 2019 Feb 21.

Department of Plastic Surgery, University of South Florida Morsani College of Medicine, Tampa.

Front Neurol 2019 19;10:102. Epub 2019 Feb 19.

Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, Netherlands.

Carotid artery dissection (CAD) and atherosclerotic carotid artery occlusion (ACAO) are major causes of a tandem occlusion in patients with intracranial large vessel occlusion (LVO). Presence of tandem occlusions may hamper intracranial access and potentially increases the risk of procedural complications of endovascular treatment (EVT). Our aim was to assess neurological, functional and technical outcome and complications of EVT for intracranial LVO in patients with CAD in comparison to patients with ACAO and to patients without CAD or ACAO. Read More

J Craniomaxillofac Surg 2019 Apr 13;47(4):561-569. Epub 2019 Feb 13.

Başkent University, Faculty of Medicine, Department of Pathology, Ankara, Turkey.

Purpose: The proximal portion of the optic nerve is quite prone to injury at the entrance of the optic foramen by tumoral or traumatic pathologies. As a result, it is important to show which way and which part we can effectively and safely decompress the pathologies affecting the optic nerves. In this study, we compared the decompression of the proximal segment of the optic canal Likewise, we investigated the anatomy and histopathology of the opticocarotid region from below and above. Read More

SAGE Open Med Case Rep 2019 25;7:2050313X19831117. Epub 2019 Feb 25.

Vascular Surgery Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.

Thrombosis, especially in pregnancy, is due to a prothrombotic state and involves the venous system. Localization in an arterial segment is rare. Floating carotid arterial thrombosis is a very rare occurrence, but it is very devastating. Read More

EJVES Short Rep 2019 13;42:26-30. Epub 2019 Feb 13.

Vascular Surgery Department, Heart and Vessels Division, Hospital de Santa Maria (CHLN), Lisbon, Portugal.

Introduction: The stent assisted balloon induced intimal disruption and relamination in aortic dissection repair (STABILISE) technique is being increasingly used for the treatment of complicated aortic dissections. However, as it is a fairly recent technique, the scientific information is limited.

Report: In this paper we report two cases of the STABILISE technique associated with procedures in the ascending aorta and supra-aortic trunks, consisting of a "frozen elephant trunk" procedure in one case and in the other, a carotid endarterectomy associated with reimplantation of the vertebral artery and partial arch debranching. Read More

World Neurosurg 2019 Feb 28. Epub 2019 Feb 28.

Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu Medical Center, Fukuoka, Japan.

Objective: A profound understanding of the relationship between the deep cervical fasciae and the skull base is essential for skull base surgery. To our knowledge, there has been little research on the relationship between the deep cervical fasciae and inferior surface of the skull base; thus, this study aims to examine the fascial network of the skull base.

Methods: Two cadaveric heads are dissected to reveal the fascial network of the skull base and 19 sides of cadaveric heads were used to reveal an anatomical variant of the pterygospinous and pterygoalar ligaments/muscles. Read More

J Clin Ultrasound 2019 Feb 28. Epub 2019 Feb 28.

Neonatology Department, University Hospital Puerta del Mar, Cadiz, Spain.

Internal carotid arterial dissection is a rare and probably underestimated cause of neonatal stroke. We report a case of neonatal stroke underscoring the role of Doppler sonography of the intracranial arteries for the diagnosis and follow-up tool. Read More

Eur J Cardiothorac Surg 2019 Feb 26. Epub 2019 Feb 26.

Department of Cardiovascular Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.

Objectives: This study aimed to evaluate the efficacy and safety of a handmade fenestrated stent graft over an aortic stent graft for preserving the left subclavian artery (LSA) in thoracic endovascular aortic repair (TEVAR).

Methods: From July 2015 to October 2018, a total of 32 consecutive patients with various thoracic aortic pathologies who underwent TEVAR in which handmade fenestration over a thoracic aortic stent graft was used for LSA were included. Outcomes including technical success, procedure-related complications, perioperative mortality and morbidity and graft patency were analysed. Read More

Interv Neuroradiol 2019 Feb 25:1591019919830215. Epub 2019 Feb 25.

Department of Surgical Sciences, University Hospital, Uppsala, Sweden.

Aim Of The Study: To present our experience in the treatment of iatrogenic dissections of extracranial internal carotid and vertebral arteries with the Neuroform Atlas stent.

Materials And Methods: Between January 2017 and February 2018 we treated iatrogenic dissections of three internal carotid arteries and three vertebral arteries. These iatrogenic dissections occurred during the endovascular treatment of ruptured and unruptured intracranial aneurysms. Read More

JAMA Neurol 2019 Feb 25. Epub 2019 Feb 25.

Clinical Neuroscience, St George's University of London, London, England.

Importance: Extracranial carotid and vertebral artery dissection is an important cause of stroke, particularly in younger individuals. In some but not all observational studies, it has been associated with a high risk of recurrent stroke. Both antiplatelet agents (APs) and anticoagulants (ACs) are used to reduce stroke risk, but whether 1 treatment strategy is more effective is unknown. Read More

J Vasc Surg 2019 Mar;69(3):952-964

Department of Angiology and Vascular Surgery, Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal; Faculdade de Medicina da Universidade do Porto, Porto, Portugal.

Objective: Acute carotid stent thrombosis (ACST) occurring in the first hours after the procedure is an exceedingly rare complication of carotid artery stenting, but it is potentially devastating. This review aimed to evaluate current literature, identifying all reported cases during the last two decades, with the final purpose of reporting predictive factors and early management.

Methods: A systematic review and meta-analysis was conducted according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Read More

J Neurosurg 2019 Feb 22:1-8. Epub 2019 Feb 22.

OBJECTIVEDuring the microsurgical clipping of known aneurysms, angiographically occult (AO) aneurysms are sometimes found and treated simultaneously to prevent their growth and protect the patient from future rupture or reoperation. The authors analyzed the incidence, treatment, and outcomes associated with AO aneurysms to determine whether limited surgical exploration around the known aneurysm was safe and justified given the known limitations of diagnostic angiography.METHODSAn AO aneurysm was defined as a saccular aneurysm detected using the operative microscope during dissection of a known aneurysm, and not detected on preoperative catheter angiography. Read More

Surg Neurol Int 2019 25;10:11. Epub 2019 Jan 25.

Michigan State University College of Human Medicine, 15 Michigan St NE, Grand Rapids, MI, 49503, USA.

Background: Ehlers-Danlos type IV primarily affects collagen synthesis in the vasculature, increasing the risk of these patients to have dissection and pseudoaneurysm formation. Due to friable vessels, antiplatelet or anticoagulation has been the treatment of choice. However, newer intravascular surgical devices may be promising for future management. Read More

Ann Vasc Surg 2019 Feb 13. Epub 2019 Feb 13.

Department of Cardiovascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, People's Republic of China. Electronic address:

Background: Retrograde type A dissection (RTAD) is a serious complication after ascending aorta involved endovascular repair (AAIER). We here report our surgical approach to this serious complication.

Methods: From July 2011 to July 2014, 8 RTADs after AAIER patients received surgical repair in our institution. Read More

Ann Vasc Surg 2019 Feb 13. Epub 2019 Feb 13.

Department of Vascular and Endovascular Surgery, "San Giovanni-Addolorata Hospital", Rome, RM, Italy.

Spinal cord ischemia is one of the most unpredictable and feared complications after open surgical or endovascular thoracic aortic repair. Protection of collateral network branches that contribute blood supply to spinal cord is fundamental in the prevention of this catastrophic condition. We report the case of a patient who underwent emergent endovascular treatment for a type B aortic dissection complicated by rupture of the false lumen, with intentional coverage of the left subclavian artery without revascularization. Read More

J Stomatol Oral Maxillofac Surg 2019 Feb 11. Epub 2019 Feb 11.

Centre hospitalier intercommunal, chirurgie maxillo-faciale, Villeneuve Saint Georges 94195, France; CHU Bouaké, Bouaké, Cote d'Ivoire.

Vascular variations are common. A cervicofacial anatomical dissection carried out at the anatomy laboratory allowed us to document a rare vascular variation. The facial artery did not give rise to branches that led to the submandibular gland; an artery arising directly from the external carotid artery vascularized the submandibular gland and gave rise to the ascending palatine artery that led to the maxilla. Read More

Ann Vasc Surg 2019 Feb 11. Epub 2019 Feb 11.

Department of Vascular Surgery, Singapore General Hospital, Singapore; Vascular Service, Sengkang General Hospital, Singapore.

Background: Endovascular aneurysm sealing (EVAS) was developed with the intention of expanding the anatomical limitations of conventional endovascular aneurysm repair devices and decrease rates of reintervention secondary to migration and type II endoleaks in treatment of abdominal aortic aneurysms. Since its inception, EVAS has gained much popularity especially for patients with concomitant common iliac aneurysms, with good long-term durability suggested by several studies. Currently, the known complications of EVAS, while considered uncommon, include endoleaks, renal artery, and limb thrombosis. Read More