• Journal of Korean Neurosurgical Society
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• v.42 no.2
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• pp.125-128
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• 2007

The incidence of spontaneous recanalization after traumatic internal carotid artery occlusion is very rare. We have experienced a case of spontaneous recanalization after a traumatic internal carotid artery occlusion. A 5-year-old boy developed contra-lateral hemiparesis and dysphasia after a blunt injury on the head and neck. He had a complete left internal carotid artery occlusion which was diagnosed through angiography. We treated the patient with an anti platelet agent and rehabilitation. Six months later, he regained motor power of right extremities, language ability, and revisualization of internal carotid artery on the follow-up magnetic angiography. We confirmed a recanalization of injured internal carotid artery on the conventional cerebral angiography which was performed one year later. We suggest conservative treatment with serial angiographic studies as a possible option of traumatic internal carotid artery occlusion even though there is hemodynamic instability.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.25 no.1
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• pp.1-12
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• 2023

Objective: Although chronic carotid artery occlusion seems to be associated with significant risk of ischemic stroke, revascularization techniques are neither well established nor widespread. In contrast, extracranial-intracranial bypass is common despite the lack of evidence regarding neurological improvement or prevention of ischemic events. The aim of current review is to evaluate the effectiveness of various methods of recanalization of chronic carotid artery occlusion. Methods: Comprehensive literature search through PubMed, Scopus, Cochrane and Web of Science databases performed. Various parameters were assessed among patients underwent surgical, endovascular and hybrid recanalization for chronic carotid artery occlusion. Results: 40 publications from 2005 to 2021 with total of more than 1300 cases of revascularization of chronic carotid artery occlusion have been reviewed. Further parameters were assessed among patients underwent surgical, endovascular and hybrid recanalization for chronic carotid artery occlusion: mean age, male to female ratio, mean duration of occlusion before treatment, rate of successful recanalization, frequency of restenosis and reocclusion, prevalence of ischemic stroke postoperatively, neurological or other symptoms improvement and complications. Based on proposed through reviewed literature indications for revascularization and predictive factors of various recanalizing procedures, an algorithm for clinical decision making have been formulated. Conclusions: Although treatment of chronic carotid artery occlusion remains challenging, current literature suggests revascularization as single option for verified neurological improvement and prevention of ischemic events. Surgical and endovascular procedures should be taken into account when treating patients with symptomatic chronic carotid artery occlusion.

• Journal of Korean Neurosurgical Society
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• v.45 no.4
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• pp.236-239
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• 2009

Carotid occlusion is an inevitable therapeutic modality for the treatment of complex aneurysms such as giant, traumatic, and intracavernous aneurysms. Late complications of carotid occlusion include 'de novo' aneurysm formation at a distant site because of hemodynamic changes in the circle of Willis. We report a case of de novo aneurysm in a vessel that appeared to be normal on initial angiography. The patient developed an anterior communicating artery aneurysm and marked growth of a basilar bifurcation aneurysm 9 years after trapping of the left internal carotid artery for the treatment of a ruptured large saccular aneurysm involving ophthalmic and cavernous segments. We propose that patients who undergo therapeutic carotid occlusion should be periodically followed by magnetic resonance angiography or computed tomographic angiography to evaluate the possibility of de novo aneurysm formation; this advice is in line with previous reports.

• Korean Journal of Bronchoesophagology
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• v.5 no.2
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• pp.202-206
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• 1999

A carotid artery resection and replacement including neck dissection are used as a method of treatment for head and neck cancer with infiltration into the carotid artery. The recent development of imaging technique makes it easy to estimate the detailed anatomical relationship between the tumor infiltration into the carotid artery, it's resection and replacement are indicated at radical neck dissection. To detect any possibility of cerebral ischemia at the time of ligation of carotid artery, a temporary occlusion test of internal carotid artery with a ballon catheter (balloon occlusion test) is performed. Recently, we performed a carotid artery resection and replacement using an artificial vessel Gore-Tex) in a case of neck cancer with infiltration into the carotid artery.

• Journal of Korean Neurosurgical Society
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• v.52 no.6
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• pp.551-554
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• 2012

Alternative to carotid endarterectomy, carotid artery stenting (CAS) can be performed for symptomatic severe stenosis of internal carotid artery, especially for high-risk patients. Among several complications after CAS, subacute in-stent thrombosis is rare but important, because patient's condition can deteriorate rapidly. Subacute in-stent thrombosis with carotid artery occlusion can be managed by superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis. We report two cases of STA-MCA anastomosis for internal carotid artery occlusion by subacute in-stent thrombosis after CAS.

• Journal of Korean Neurosurgical Society
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• v.41 no.5
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• pp.323-326
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• 2007

Direct carotid-cavernous fistula [CCF] is a common post-traumatic disease. However, pseudoaneurysm formation after balloon occlusion is a rare complication. The author present such a case with review of the literature. A 26-year-old man involved in a motor vehicle accident as a driver. Only mild conjunctival injection and minimal exophthalmos on the right eye were noted after trauma. However, angiography revealed a direct CCF and dissection of the proximal intracranial internal carotid artery [ICA]. After first balloon occlusion of the CCF, the patient redeveloped fistula due to early deflation of the balloon. After the second balloon occlusion, pseudoaneurysm and diplopia were developed with the change of balloon position and shape. However, visual symptom spontaneously resolved and pseudoaneurysm was also decreased within 6 months after balloon occlusion.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.25 no.3
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• pp.306-310
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• 2023

Traumatic internal carotid artery injuries can produce direct carotid-cavernous fistulas as well as giant internal carotid artery pseudoaneurysms. Clinical sequelae can include headaches, cranial nerves palsies, proptosis, chemosis and optic neuropathy with visual loss as the most dangerous complication. Herein, we present a case of one of the largest reported internal carotid artery pseudoaneurysms associated with a direct carotid cavernous fistula. We describe the techniques and pitfalls of treatment with parent vessel occlusion.

• Biomolecules & Therapeutics
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• v.9 no.2
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• pp.96-103
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• 2001

These studies were investigated about influence of SKP 450, a $K^{+}$ channel opener, on the pressor actions induced by norepinephrine, angiotensin II and carotid artery occlusion in rats. Before these studies, effect of SKP 450 itself on blood pressure was examinated. SKP 450 produced the depressor action in proportionaly to dose of 0.3, 1.0 and 3.0 $\mu$g/kg given intravenously and this depressor action was weakened by pretreatment of glibenclamide, a $K^{+}$ channel blocker. The pressor action induced by norepinephrine, an alpha-adrenergic agonist, was blocked 1 hr after administation of SKP 450 in a dose of 3.0 $\mu\textrm{g}$/kg, i.v. and directly after in a dose of 6.0 $\mu\textrm{g}$/kg, i.v.. The pressor action induced by angiotensin II was blocked immediatly after treatment of SKP 450 in a dose of 3.0 $\mu\textrm{g}$/kg, i.v.. The pressor action caused by carotid artery occlusion was not affected by SKP 450 of 3.0 $\mu\textrm{g}$/kg, i.v., whereas markedly blocked by SKP 450 of 6.0 $\mu\textrm{g}$/㎦, i.v.. The potentiated-pressor actions of norepinephrine and angiotensin II by pretreatment of chlorisondamine, a autonomic ganglionic blocking agent, were also blocked by administration of SKP 450 in a dose of 6.0 $\mu\textrm{g}$/kg, i.v.. The weakened-pressor action of carotid artery occlusion by pretreatment of chlorisondamine was more weakened by SKP 450 6.0 $\mu\textrm{g}$/kg, i.v.. The results suggest that hyperpolarization formed through $K^{+}$ channel opening in cell membrane inhibits the pressor action induced norepinephrine ; angiotensin II ; and carotid artery occlusion.usion.

• Journal of Korean Neurosurgical Society
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• v.55 no.6
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• pp.313-320
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• 2014

Objective : The purpose of this study is to demonstrate the technical feasibility and clinical efficacy of emergent carotid angioplasty and stenting (CAS) for acute stroke due to athero-thrombotic occlusion of the cervical internal carotid artery (ICA). Methods : Review of medical records identified 17 patients who underwent emergent CAS for treatment of athero-thrombotic occlusion of the cervical ICA with acute stroke between 2009 and 2013. Eleven patients (64.7%) presented with concomitant intracranial artery occlusion, which was treated primarily by mechanical thrombectomy after CAS. Results : Successful revascularization of the cervical ICA with emergent CAS was achieved in all patients. After CAS, intracranial recanalization with Thrombolysis in Cerebral Infarction ${\geq}2b$ flow was achieved in four of the 11 patients (36.4%). The overall recanalization rate (cervical ICA and intracranial artery) was 10 of 17 patients (58.8%). Symptomatic intracranial hemorrhage occurred in two patients (11.8%), resulting in death. Ten patients (58.8%) showed improvement (decrease in NIHSS score of ${\geq}4$ points) at seven days after recanalization. Nine patients (52.9%) showed a favorable outcome ($mRS{\leq}2$) at the last follow-up. A favorable outcome ($mRS{\leq}2$) was obtained in four of the six patients with isolated cervical ICA occlusion (4/6, 66.7%) and five of 11 patients with intracranial tandem occlusion (5/11, 45.5%). Conclusion : Emergent CAS for acute stroke due to athero-thrombotic occusion of the cervical ICA showed a good technical feasibility and favorable clinical outcome.

• Journal of Korean Neurosurgical Society
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• v.41 no.3
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• pp.200-203
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• 2007

We describe a case that showed augmention of the superficial temporal artery [STA] pedicle's patency 15 months after extracranial to intracranial [EC-IC] bypass surgery for a carotid artery occlusion with contralateral intracranial internal carotid artery stenosis. It is rare that meager patency of the STA pedicle in the early postoperative angiogram can be become well augmented with time where most branches of the middle cerebral artery [MCA] are robustly filled with blood from the STA. A 28-year-old woman with a history of a previous left hemispheric stroke presented with slurred speech after several bouts of seizure. Magnetic resonance imaging showed a new infarct on the right hemisphere in addition to an old infarct on the left hemisphere. Carotid angiography revealed stenosis of the right carotid siphon and occlusion of the left carotid artery. The patient underwent EC-IC bypass on the right side. Even though the early postoperative angiogram showed meager filling of MCA with no significant stenotic lesion change, a subsequent angiogram taken 15 months later, demonstrated a widely patent STA pedicle with occlusion of the previous intracranial stenotic lesion. Selected cases with an inaccessible intracranial stenotic lesion can benefit from EC-IC bypass surgery; however, its clear indication should first be established.