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Combined interventional and surgical treatment of tandem middle cerebral artery embolus and internal carotid artery occlusion: case report.
Abstract Tandem internal carotid artery (ICA) origin occlusion and middle cerebral artery (MCA) thromboembolism is a life-threatening condition with poor neurological outcome. The authors report on a patient presenting with acute ischemic stroke from a tandem ICA and MCA occlusion with penumbra. Emergency MCA mechanical thrombectomy was performed through percutaneous cervical ICA access due to the inability to cross the cervical carotid occlusion. Emergency carotid endarterectomy to reperfuse the poorly collateralized hemisphere and repair the ICA access site was performed 2 hours after completion of tissue plasmi...
Source: Journal of Neurosurgery - November 17, 2017 Category: Neurosurgery Authors: Frenkel MB, Renfrow JJ, Singh J, Garg N, Wolfe SQ Tags: J Neurosurg Source Type: research

Emergent intracranial surgical embolectomy in conjunction with carotid endarterectomy for acute internal carotid artery terminus embolic occlusion and tandem occlusion of the cervical carotid artery due to plaque rupture.
Abstract Acute internal carotid artery (ICA) terminus occlusion is associated with extremely poor functional outcomes or mortality, especially when it is caused by plaque rupture of the cervical ICA with engrafted thrombus that elongates and extends into the ICA terminus. The goal of this study was to evaluate the efficacy and safety of surgical embolectomy in conjunction with carotid endarterectomy (CEA) for acute ICA terminus occlusion associated with cervical plaque rupture resulting in tandem occlusion. A retrospective review of medical records was performed. Clinical and radiographic characteristics were eval...
Source: Journal of Neurosurgery - January 9, 2015 Category: Neurosurgery Authors: Hasegawa H, Inoue T, Tamura A, Saito I Tags: J Neurosurg Source Type: research

64-detector CT angiography within 24 hours after carotid endarterectomy and correlation with postoperative stroke.
CONCLUSIONS CTA within 24 hours of CEA demonstrates characteristic anatomical findings. CCA step-offs and ECA flaps are relatively common and clinically insignificant, whereas ICA/CCA flaps and thrombi are less frequently seen and are associated with postoperative stroke/TIA. PMID: 25555168 [PubMed - as supplied by publisher]
Source: Journal of Neurosurgery - January 2, 2015 Category: Neurosurgery Authors: Gallati CP, Jain M, Damania D, Kanthala AR, Jain AR, Koch GE, Kung NT, Wang HZ, Replogle RE, Jahromi BS Tags: J Neurosurg Source Type: research