Origin Of Common Carotid Artery Research Articles

Stenting for subclavian steal phenomenon to restore cerebral perfusion due to acute carotid occlusion following carotid endarterectomy: a case report

BackgroundPerioperative symptomatic carotid artery occlusion after carotid endarterectomy is a rare complication. In this study, we present a case of symptomatic acute carotid artery occlusion that occurred after carotid endarterectomy in a patient with coexistent subclavian artery steal phenomenon, which was successfully treated with subclavian artery stenting.Case presentationA 57-year-old East Asian female presented with stenosis in the left common carotid artery and left subclavian artery along with subclavian steal. The proximal segment of the left anterior cerebral artery was hypoplastic, and the posterior communicating arteries on both sides were well-developed. Left internal carotid artery stenosis progressed during the follow-up examination; therefore, left carotid endarterectomy was performed. On the following day, symptoms of cerebral perfusion deficiency appeared due to occlusion of the left carotid artery. The stenotic origin of the left common carotid artery and the suspected massive thrombus in the left carotid artery posed challenges to carotid revascularization. Therefore, left subclavian artery stenting for the subclavian steal phenomenon was determined to be the best option for restoring cerebral blood flow to the whole brain. Her symptoms improved after the procedure, and the postprocedural workup revealed improved cerebral blood flow.ConclusionSubclavian artery stenting is safe and may be helpful in patients with cerebral perfusion deficiency caused by intractable acute carotid occlusion coexisting with the subclavian steal phenomenon. Revascularization of asymptomatic subclavian artery stenosis is generally not recommended. However, cerebral circulatory insufficiency as a comorbidity may be worth considering.

Case Report: A pyramidal lobe coexisting with a left-sided thyroid goiter displacing trachea and esophagus: A cadaveric finding with clinical implications

Background The current report describes a unimodular thyroid goiter (TGo), identified unilaterally in a female cadaver, causing displacement or compression effects in the adjacent neck structures (common carotid artery (CCA) and internal jugular vein (IJV),). Methods Routine dissection of the neck of an 86-year-old female donated a Greek cadaver. Results A thyroid gland variant was identified coexisting with a TGo originating from the left thyroid lobe. The variant is a pyramidal lobe located on the left side of the isthmus. Owing to the presence of the TGo, the left CCA, along with the left IJV, deviated 50.6 mm ipsilaterally from the midline of the neck. The right CCA had a minor deviation of 30.8 mm, from the midline to the right side due to the proximity of the shifted trachea and esophagus with the CCA origin. The trachea and esophagus deviated contralaterally to the TGo, 24.4 mm from the midline. Conclusions CCA compression, stenosis, and angulation may cause dizziness, weakness, and hypomnesia. The potential outcomes were worse with IJV compression. Atherosclerosis tends to occur more often in arteries with inclined (angulated) parts.

A case of penetrating neck injury in zone II treated with combined endovascular and surgical management

AbstractBackgroundWe report a case of zone II penetrating neck trauma with active bleeding in which endovascular treatment was performed prior to neck exploration to identify and control the bleeding point.Case PresentationA man in his 50s presented to our emergency department in hemorrhagic shock stemming from a penetrating knife wound injury to the right side of his neck. He was bleeding massively from the right neck wound and oral cavity. Cervical angiography showed bleeding from the right external carotid artery and intimal injury to the right internal carotid artery. Balloon occlusion at the common carotid artery origin and distal to the injured internal carotid artery controlled active bleeding. During vascular balloon occlusion, definitive hemostatic treatment was achieved through ligation of the proximal external carotid artery.ConclusionNeck exploration combined with endovascular treatment may be one option as a treatment strategy for patients with zone II penetrating neck injury.

Impact on hemodynamics in carotid arteries with carotid webs at different locations: A Numerical Study Integrating Thrombus Growth Model

ObjectiveCarotid webs (CWs), lesions in the carotid arteries, are gaining research interest due to the unclear link to ischemic stroke. Similarity to atherosclerosis in lesion location adds the complexity. The main purpose of study is to investigate the hemodynamic effects of CWs at different locations in carotid arteries. MethodsThree types of models with CWs were reconstructed from the CTA dataset of 8 healthy carotid arteries (Models A: CWs at the common carotid artery; B: at the origin of internal carotid artery; C: at the carotid sinus). Wall shear stress (WSS)-based parameters, including time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), relative residence time (RRT), and endothelial cell activation potential (ECAP) were analyzed. A thrombus growth model was also incorporated to assess long-term thrombus formation across different carotid webs locations. ResultsModels A exhibited helical flow, whereas models B and C showed disturbed flow in the carotid sinus. Recirculation in Models A and B was mainly downstream of CWs, while Models C had both upstream and downstream recirculation. In addition, models A had higher overall TAWSS levels, with the smallest region of TAWSS < 0.4 pa (7.78 ± 8.35%). In contrast, Models C had larger areas with TAWSS < 0.4 pa, RRT > 100, and ECAP > 1.5, accounting for 14.18 ± 5.28%, 1.51 ± 1.17%, and 10.36 ± 4.10%, respectively. Noting that thrombus volume was highest in Models C (7.20 ± 3.95%). ConclusionsNumerical simulations indicate that: 1) CWs have less hemodynamic impact when located in the CCA, but may increase flow resistance leading to distal branch ischemia; 2) CWs contribute to thrombus formation, primarily downstream in the common carotid artery and internal carotid artery origin, and both upstream and downstream in the sinus; 3) CWs at the origin of the ICA are more likely to result in disturbed blood flow patterns and thrombus aggregation than the other two locations, which may increase the risk of ischemic stroke in distal cerebral arteries.

A Simple Technique for Deploying the SENTINEL Cerebral Protection System in Bovine Aortic Arch Anatomy

The SENTINEL Cerebral Protection System is one of the most commonly used devices for embolic protection during transcatheter aortic valve replacement. However, successful deployment of the SENTINEL device is often challenging in patients with a bovine aortic arch anatomy using the standard technique and requires extensive manipulation in the aortic arch increasing the risk of stroke. We describe a novel and simple technique of 2-filter deployment of SENTINEL device in patients with bovine arch anatomy. In this technique, after the deployment of the proximal filter, the device is hyperflexed on itself facing the lateral aspect of the ascending aorta instead of facing the descending aorta, with its tip pointing toward the common origin of the left common carotid artery (LCCA) and brachiocephalic trunk. The guidewire is then advanced to the LCCA. Since the guidewire can pass either anterior or posterior to the device shaft, the device needs to be untwisted either by clockwise or counterclockwise motion, before pulling the device shaft back to engage the LCCA, after which the distal filter can be deployed. Computed tomography scans obtained for planning transcatheter aortic valve replacement should be reviewed for the presence of bovine aortic arch anatomy so that this technique can be deployed directly, thereby reducing manipulations in the aortic arch, saving time, and not requiring additional equipment.

Evaluation of a novel polymer coil for endovascular occlusion of intracranial aneurysms in a rabbit model.

The results of the preclinical study of a novel polymer coil in treatment of elastase induced aneurysms will be presented in this paper. We induced 16 aneurysms in 16 New Zealand white rabbits at the origin of the right common carotid artery at the brachiocephalic trunk. Newly developed polymer coils in both groups for six aneurysms each and platinum coils for two aneurysms each were used. Control angiographies followed in both groups immediately after coiling as well as in the first eight animals 30days after intervention (30days group) and in the other eight animals 90days after (90days group). An explanation and histological evaluation of the treated aneurysms followed. The 12 animals in which the aneurysms were treated with polymer coils showed a complete occlusion (grade IV) in only 6 out of 12 aneurysms (50%), an almost complete occlusion (grade III) in 5 out of 12 (42%) and an incomplete occlusion in the treatment of one aneurysm (8%). Histologically, we observed a significantly more pronounced inflammatory response and neoangiogenesis in aneurysms treated with polymer coils only in the 30days group. Most difficulties and concerns with the polymer coils were related to the flexibility and detachment behaviour. Therefore, and due to the technical challenges of delivery, the novel polymer coil cannot be considered an alternative to the current platinum coils.

Immediate Angioscopic Investigation After Cerebral Artery Thrombectomy Revealed Aortogenic Cerebral Infarction

Background Aortogenic embolism is one of the causes of embolic stroke of undetermined source, which can be difficult to diagnose. Methods We present the case of a 74‐year‐old male patient with a history of Bentall surgery and thoracic endovascular aortic repair who was transported to our hospital with sudden‐onset right‐sided hemiplegia and total aphasia. Magnetic resonance imaging revealed an acute left middle cerebral artery occlusion. Subsequently, an emergency mechanical thrombectomy was performed, through which the left middle cerebral artery was partially reperfused. We immediately investigated the aorta using an angioscopy. Results The angioscopy revealed a thrombus attached to an artificial blood vessel of the aorta close to the origin of the left common carotid artery. Because no other source of the embolus could be identified using electrocardiography or ultrasound, we diagnosed an aortogenic cerebral infarction by combining these findings with the pathological findings of the collected thrombus. Conclusions This is the first report that aortogenic cerebral infarction could be diagnosed using an angioscopy immediately after a cerebral artery thrombectomy.

Optimal guiding catheter position during advancement of the guiding catheter into the carotid artery from the aortic arch via transfemoral approach.

Guiding catheter (GC) advancement into the target carotid artery is a crucial step in neuroendovascular therapy. In difficult anatomies, alternative methods have been reported to overcome difficult carotid access for swift GC advancement. However, studies focusing on the positional relationship between the GC and inner catheter (IC) at the aortic arch are lacking. We evaluated the impact of the positional relationship between the GC and IC on whether the GC position affects catheter support or system straightening. We retrospectively reviewed 89 patients who underwent neuroendovascular therapy. We assessed the time to carotid access across difficult arch anatomies. The GC position was divided into Position 1, descending aorta level; Position 2, aortic arch level; and Position 3, origin of the left common carotid artery or innominate artery. We also evaluated the GC support and straightening effects in an in vitro vascular model study. The coaxial catheter flexion angle at the aortic arch was significantly larger when the GC was set to Position 3 (p < 0.0001). A significantly shorter time to carotid access was observed with Positions 2 and 3 than with Position 1 in the difficult arch anatomy group. In the in vitro vascular model evaluation, the catheter support effect significantly increased as the GC position became closer to the IC tip (p < 0.0001) and straightening effect significantly increased as the GC moved to Position 2 from Position 1 (p < 0.0001). During GC advancement, the GC positional relationship changed the support of the coaxial system with system straightening. The optimal GC position, Position 3, facilitated swift GC advancement.

Morphometry of Arch of Aorta and its Branches- A Cadaveric Cross-sectional Study

Introduction: The Arch of Aorta (AA) originates from the ascending aorta in the superior mediastinum, specifically at the level of the right 2nd costal cartilage, behind the lower half of the manubrium sterni. The AA typically gives rise to three major arteries, namely the brachiocephalic trunk, left common carotid, and left subclavian, which is the most common branching pattern. Aim: To investigate the morphometric parameters of the AA and its branches, including the diameters, angles formed by the branches with the AA, and the distance of origin of these branches from the mid vertebral line. Materials and Methods: This descriptive observational cross- sectional study was conducted in the Department of Anatomy at NRI Medical College, Guntur, Andhra Pradesh, India,, from June 2017 to August 2021. A total of 50 aortic arches, along with their branches, were examined from cadavers (45 males, 5 females) assigned to 1st-year MBBS students for regular dissection practicals. Measurements such as the diameter of the arch at its origin and termination, diameter of major vessels at their origin, angles made by major vessels at their origin with the convexity of the arch, and the distance of origin of major branches from the midvertebral line were recorded. Vernier calipers with an accuracy of 0.01 mm were used to measure various parameters, and angles were measured using a Goniometer. Mean and Standard Deviation (SD) were calculated for each parameter using an MS Excel sheet. Results: The distance of origin of the brachiocephalic trunk from the midvertebral line was found to be 1.86±5.13 mm to the right of the midline, while the distance of origin of the Left Common Carotid Artery (LCCA) and Left Subclavian Artery (LSA) from the midvertebral line were +12.68±6.43 mm and +26.31±6.73 mm, respectively. The diameters of the mentioned branches at their origin were 11.22±2.29 mm, 7.39±1.49 mm, and 8.38±2.15 mm, and the angles made by these branches with the aortic arch were 89.10±18.48, 73.52±14.55, and 73.93±16.80 degrees, respectively. Conclusion: The morphometric parameters of the AA and its branches, as observed in the present study, hold significant clinical importance and can be valuable for cardiothoracic and vascular surgeons working in this region.

Morphometry of Arch of Aorta and its Branches- A Cadaveric Cross-sectional Study

Introduction: The Arch of Aorta (AA) originates from the ascending aorta in the superior mediastinum, specifically at the level of the right 2nd costal cartilage, behind the lower half of the manubrium sterni. The AA typically gives rise to three major arteries, namely the brachiocephalic trunk, left common carotid, and left subclavian, which is the most common branching pattern. Aim: To investigate the morphometric parameters of the AA and its branches, including the diameters, angles formed by the branches with the AA, and the distance of origin of these branches from the mid vertebral line. Materials and Methods: This descriptive observational cross- sectional study was conducted in the Department of Anatomy at NRI Medical College, Guntur, Andhra Pradesh, India,, from June 2017 to August 2021. A total of 50 aortic arches, along with their branches, were examined from cadavers (45 males, 5 females) assigned to 1st-year MBBS students for regular dissection practicals. Measurements such as the diameter of the arch at its origin and termination, diameter of major vessels at their origin, angles made by major vessels at their origin with the convexity of the arch, and the distance of origin of major branches from the midvertebral line were recorded. Vernier calipers with an accuracy of 0.01 mm were used to measure various parameters, and angles were measured using a Goniometer. Mean and Standard Deviation (SD) were calculated for each parameter using an MS Excel sheet. Results: The distance of origin of the brachiocephalic trunk from the midvertebral line was found to be 1.86±5.13 mm to the right of the midline, while the distance of origin of the Left Common Carotid Artery (LCCA) and Left Subclavian Artery (LSA) from the midvertebral line were +12.68±6.43 mm and +26.31±6.73 mm, respectively. The diameters of the mentioned branches at their origin were 11.22±2.29 mm, 7.39±1.49 mm, and 8.38±2.15 mm, and the angles made by these branches with the aortic arch were 89.10±18.48, 73.52±14.55, and 73.93±16.80 degrees, respectively. Conclusion: The morphometric parameters of the AA and its branches, as observed in the present study, hold significant clinical importance and can be valuable for cardiothoracic and vascular surgeons working in this region.

Dizziness Result From Anomalous Origin of Left Common Carotid Artery.

The anomalous origin of the left common carotid artery from the pulmonary artery is extremely scarce. At present, there are few relevant research and medical treatment data. This case is intended to provide relevant information and share treatment experiences. Case information: A 6-year-old child was diagnosed with patent ductus arteriosus and underwent surgery five years ago with occasional dizziness. After examination, it was found that the abnormality of her left common carotid artery originated from the pulmonary artery, and the patient underwent arterial ligation with the monitoring of cerebral oxygen consumption by near-infrared spectroscopy after careful preoperative evaluation. At present, it has been two years after the operation, and the patient is in good condition and has received regular follow-up. For patients with an abnormal left common carotid artery from the pulmonary artery, after careful preoperative evaluation such as cerebral angiography, under the monitoring of cerebral oxygen consumption by near-infrared spectroscopy, ligation of the proximal end of the artery of abnormal origin is safe and feasible.

An Improved Surgical Technique to Increase Neck Width of Elastase-Induced Aneurysm Model in Rabbits: A Prospective Study

BackgroundRabbit elastase-induced aneurysms have widely been used to test various endovascular materials over the past two decades. However, wide-necked aneurysms cannot be stably constructed.ObjectiveThe purpose of the study was to increase the neck width of the elastase-induced aneurysm model in rabbits via an improved surgical technique with two temporary clips.Materials and MethodsFifty-four elastase-induced aneurysms in rabbits were successfully created. Group 1 was (n = 34) composed of cases in which two temporary aneurysm clips were placed closely medially and laterally to the origin of the right common carotid artery (RCCA), respectively. Group 2 (n = 20) included cases in which a single temporary aneurysm clip was placed crossed the origin of RCCA. Digital subtraction angiography (DSA) was performed before and immediately after elastase incubation and 3 weeks later. The diameter of the origin of RCCA before and immediately after elastase incubation and aneurysm sizes of the two groups were measured and compared. Moreover, the correlation analysis was performed between the diameter of the origin of RCCA immediately after elastase incubation and aneurysm neck width.ResultsThe mean aneurysm neck and dome width of group 1 were both significantly larger than that of group 2 (p-value < 0.001 and p-value = 0.005, respectively). Moreover, the proportion of wide-necked aneurysms (neck width ≥4 mm) in group 1 was significantly larger than that in group 2 (p-value = 0.004) and the mean dome to neck ratio (D/N) of group 1 was smaller than that of group 2 (p-value = 0.008). Furthermore, there was a positive correlation between the diameter of the origin of RCCA immediately after elastase incubation and aneurysm neck width.ConclusionThe improved surgical technique with two temporary clips, focusing on the direct contact of elastase with the origin of RCCA, could increase the neck width of elastase-induced aneurysm models in rabbits.

Origin of the Left Common Carotid Artery from the Brachiocephalic Artery Trunk

The origin of the left common carotid artery from the brachiocephalic arterial trunk is a rare anatomical malformation. We report the case of a 54-year-old man with aortic stenosis on a bicuspid aortic valve with dilatation of the ascending aorta.

Abnormal origin of the vertebral arteries with Bicarotid trunk: a case report

BackgroundAortic arch and vertebral artery anomalies are vascular variations that occur as a result of embryological developmental defects. Bicarotid trunk anomaly is a rare aortic arch anomaly and refers to a common single trunk origin of common carotid arteries. VA origin anomalies are mostly unilateral and the most common is the LVA originating from the aortic arch. Abnormal origin of the RVA from the RCCA is a rare vascular anomaly. In this case, we presented ARSA and bicarotid trunk anomaly with abnormal origin of the vertebral arteries.Case presentationA 64-year-old male was admitted to our center with complaints of chronic headache and dizziness. In addition to ARSA and bicarotid trunk anomaly, RVA originating from RCCA and LVA originating from aortic arch were observed in CT angiography. The origin of LVA was between the bicarotid trunk and LSCA. Both VA were entering the transverse foramen at the level of the C6 vertebra. These anomalies were also revealed in detail by MR angiography of head/neck.ConclusionAortic arch anomalies are a group with different subtypes. Awareness of VA origin anomalies is important for planning surgical and endovascular interventional procedures.

Prenatal Diagnosis of Bovine Aortic Arch Anatomic Variant.

Fetal aortic arch development is an early and complex process that depends on many genetic and environmental factors. The final aortic arch varies greatly; it may take the form of a normal arch, anatomic variant (AAAV) with a common origin to that of the innominate artery and left common carotid artery (formerly known as “bovine aortic arch” (with an incidence of up to 27%)) or one of multiple pathological conditions. The present study aimed to establish the feasibility and impact of prenatal anatomic arch variants’ diagnosis. A retrospective study of 271 fetal second- and third-trimester anomaly scans was performed in our tertiary center. Examinations that evaluated the sagittal aortic arch were included and the branching pattern was assessed. Additionally, a literature data search based on the terms “common origin of innominate artery and left common carotid artery”, “bovine arch”, “bovine aortic” and “aortic arch anomalies” was performed. Results that referred to prenatal AAAV were retained and the papers evaluated. In our study, the AAA incidence was 1.93%, with 4 out of 5 cases being arch type B. All cases had minor associated conditions but a good postnatal outcome. An anatomic aortic variant with a common IA and LCCa prenatal diagnosis was found in a small number of studies; most of the cases described in pediatric and adult series were related to cardiac surgery for stenting, aneurysm or thoracic-associated diseases. The incidence of AAAV varied from 6 to 27% depending on the population studied (highest incidence in African individuals). The variant was highly associated with aortic dissection, pulmonary and cerebral embolism and increased risks of incidents during surgery. Diagnosing AAAV during a routine anatomic scan is feasible and diagnoses can be made when anomaly scans are performed. Awareness of the condition is important for postnatal surgery when other cardiac anomalies are found; this can prevent accidents with simple changes to the patient’s lifestyle, and, in the case of surgery, means we can adopt the correct surgical approach.

Repair of Kommerell's Diverticulum and Aberrant Subclavian Arteries: Classification of the Five Groups in Declining Frequency and Their Operative Approaches

Repair of Kommerell's Diverticulum and Aberrant Subclavian Arteries: Classification of the Five Groups in Declining Frequency and Their Operative Approaches

Investigating the Association between Aortic Arch Variants and Intracranial Aneurysms.

There is an association between anterior cerebral artery vessel asymmetry and anterior communicating artery aneurysm, presumably based on flow dynamics. The purpose of this study is to investigate the potential relationship between aortic arch branching patterns and incidence of intracranial aneurysm. This study included patients scanned over 1 year at our tertiary care center who underwent high-resolution imaging (computed tomography angiography or digital subtracted angiogram) of the head and neck arteries, aortic arch, and superior mediastinum. Exclusion criteria included patients with suboptimal images. Patient age, gender, aortic arch branching pattern, and the presence, location, and number of aneurysms were documented. Among the 1082 patients analyzed, 250 (23%) patients had a variant aortic arch branching pattern, 22 (8.8%) of whom had aneurysms. There were 104 patients with 126 aneurysms, with majority of patients with normal aortic arch branching pattern (n = 82, 79%). The most common variant was a common origin of the left common carotid artery and brachiocephalic trunk with or without direct origin of the left vertebral artery. Twenty-two patients with aneurysms had an aberrant aortic arch (21%), compared to 232 patients without an aneurysm (24%). Fischer exact test showed no statistically significant difference between the incidence of aneurysm with different aortic arch variant groups (two-tailed p-value = 0.715). To our knowledge, this is the first study to examine the association between aortic arch branching patterns and incidence of intracranial aneurysm. No significant association was found between aortic arch branching pattern and the incidence of intracranial aneurysm.

Creation of Two Saccular Elastase-Digested Aneurysms with Different Hemodynamics in One Rabbit.

Preclinical animal models with hemodynamic, morphologic, and histologic characteristics close to human intracranial aneurysms play a key role in the understanding of the pathophysiological processes and the development and testing of new therapeutic strategies. This study aims to describe a new rabbit aneurysm model that allows the creation of two elastase-digested saccular aneurysms with different hemodynamic conditions within the same animal. Five female New Zealand white rabbits with a mean weight of 4.0 (± 0.3) kg and mean age of 25 (±5) weeks underwent microsurgical stump and bifurcation aneurysm creation. One aneurysm (stump) was created by right common carotid artery (CCA) exposure at its origin at the brachiocephalic trunk. A temporary clip was applied at the CCA origin and another, 2 cm above. This segment was treated with a local injection of 100 U of elastase for 20 min. A second aneurysm (bifurcation) was created by suturing an elastase-treated arterial pouch into the end-to-side anastomosis of the right CCA to left CCA. Patency was controlled by fluorescence angiography immediately after creation. The average duration of surgery was 221 min. The creation of two aneurysms in the same animal was successful in all rabbits without complication. All aneurysms were patent immediately after surgery except for one bifurcation aneurysm, which showed an extreme tissue reaction due to elastase incubation and an immediate intraluminal thrombosis. No mortality was observed during surgery and up to one-month follow-up. Morbidity was limited to a transient vestibular syndrome (one rabbit), which recovered spontaneously within one day. Demonstrated here for the first time is the feasibility of creating a two-aneurysm rabbit model with stump and bifurcation hemodynamic characteristics and highly degenerated wall conditions. This model allows the study of the natural course and potential treatment strategies on the basis of aneurysm biology under different flow conditions.

Rendezvous endovascular common carotid artery stenting (RECCAS) technique for symptomatic steno-occlusive disease

This report describes a patient who presented with acute but transient right arm weakness and altered sensation secondary to severe stenosis of the left common carotid artery (CCA) origin. Endovascular stenting of the stenosed origin was achieved utilising a novel rendezvous technique through combined retrograde common carotid artery and anterograde transfemoral approaches. This technique has numerous potential advantages over traditional transfemoral endovascular and open retrograde common carotid artery approaches. It allows increased procedural control and success in traversing the stenosis and provides a smooth transition for the stent delivery catheter. An open cutdown procedure or open surgical technique is not required. Our patient recovered well from the procedure with no complications within the three-month follow up period.

Rabbit Elastase Aneurysm: Imaging and Histology Correlates for Inflammation and Healing

Aneurysmal subarachnoid hemorrhage remains a devastating event with poorly understood pathophysiology. Previous studies have suggested that aneurysm wall inflammation may play a part in the development and potential rupture of aneurysms. The rabbit elastase aneurysm model is a well-established model, which produces aneurysms closely mimicking human cerebral aneurysms in flow dynamics and histopathology. The primary aim of this study was to correlate inflammatory changes after aneurysm formation using sequential vessel wall imaging with histopathological analysis. A secondary aim was to evaluate the potential effect of gender and anti-inflammatory treatment with aspirin on this inflammatory response. Twenty-seven New Zealand rabbits underwent surgery to create an aneurysm using elastase infusion at the right common carotid artery origin. Vessel wall imaging and histopathological analysis was obtained at different time points after aneurysm creation. The rabbits were also randomized by gender and to treatment groups with or without aspirin. Histopathological analysis revealed three distinct phases after aneurysm formation. These phases were an initial inflammatory phase, followed by a regeneration phase, and finally a connective tissue deposition phase. Vessel wall imaging demonstrated two distinct imaging patterns. No appreciable differences were seen in histology or imaging when comparing gender or treatment with aspirin. Inflammatory changes induced by the rabbit elastase aneurysm model can be correlated with histopathological findings and observed on noninvasive vessel wall imaging. This may provide a method to study the inflammatory pathway as it pertains to aneurysmal development and subsequent rupture.