HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Symptomatic haemodynamically significant carotid occlusion treated by posterior circulation revascularization.

Abstract
Haemodynamic cerebral ischaemic symptoms secondary to occlusive atheromatous disease of the internal carotid artery may resolve with revascularization. We describe a case of symptomatic internal carotid artery occlusion and ipsilateral subclavian stenosis with duplex and angiographically demonstrated vertebrobasilar steal and a patent ipsilateral posterior communicating artery with flow towards the steal. The patient suffered frequent ipsilateral middle cerebral artery territory transient ischaemic attacks and one minor stroke. Transcranial Doppler demonstrated markedly impaired ipsilateral carbon dioxide reactivity (13.8%, lower-limit normal range >32.6%). Percutaneous angioplasty to the subclavian artery stenosis resulted in resolution of symptoms and an improvement in reactivity to near the lower limit of the normal range (33.5%). This case demonstrates that normalization of vertebral artery steal by subclavian artery revascularization may benefit anterior circulation haemodynamic symptoms in the presence of a functioning posterior communicating artery. The measurement of middle cerebral artery reactivity using transcranial Doppler can identify such cases of haemodynamic impairment and monitor the effect of therapy.
AuthorsR P White, P Barnes, H S Markus
JournalCerebrovascular diseases (Basel, Switzerland) (Cerebrovasc Dis) Vol. 8 Issue 3 Pg. 148-51 ( 1998) ISSN: 1015-9770 [Print] Switzerland
PMID9619697 (Publication Type: Case Reports, Journal Article)
Topics
  • Angiography
  • Angioplasty, Balloon
  • Arteriosclerosis (diagnosis, physiopathology, therapy)
  • Carotid Artery Diseases (diagnosis, physiopathology, therapy)
  • Carotid Artery, Internal (diagnostic imaging)
  • Cerebral Arteries (diagnostic imaging, physiopathology)
  • Constriction, Pathologic
  • Hemodynamics (physiology)
  • Humans
  • Male
  • Middle Aged
  • Subclavian Artery (diagnostic imaging)
  • Ultrasonography

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: