Major Extracranial Arteries Research Articles

ДИССЕКЦИЯ КАК ПРИЧИНА ТРОМБОЗА ВНУТРЕННЕЙ СОННОЙ АРТЕРИИ И МИШЕНЬ ДЛЯ ИНТЕРВЕНЦИОННОГО ЛЕЧЕНИЯ ИНФАРКТА ГОЛОВНОГО МОЗГА

Acute ischemic stroke is a common cause of disability and mortality. In some rare cases, it can result from the structural changes in the major extracranial arteries, including vascular dissection. Due to the low incidence, the management of the acute period of dissection-associated stroke is not completely understood. In the clinical case presented, we describe the medical history of a forty years old patient in the acute period of cerebral infarction related to the dissection of the internal carotid artery, including the techniques and possible results of endovascular therapy. In this clinical scenario of acute stroke period, emergency angioplasty and stenting of carotid artery have been shown to be a highly effective approach.

Vertebral Artery Orifice Stenosis: A Report of 43 Cases from Northwest Iran Treated with Angioplasty and Stenting

More than one quarter of all transient ischemic attacks (TIA's) and ischemic strokes involve tissue supplied by the vertebrobasilar (VB) circulation. Vertebral artery stenotic lesion, particularly at the origin of the vertebral artery, is not uncommon but it is a less studied area. Here we present our endovascular treatment experience in a group of patients with vertebral artery orifice stenosis. We enrolled a group of patients with vertebral artery orifice stenosis who presented with confirmed posterior circulation stroke. Vertebrobasilar insufficiency syndrome was confirmed by imaging studies and clinical findings. Vertebral artery stenosis diagnosed by CT or MR Angiography and confirmed by Conventional and digital subtraction angiography (DSA). Angiography was performed by using of femoral or radial artery approach. From October 2008 to January 2010, forty-three consecutive patients (69.8% men) underwent stent placement for symptomatic vertebral artery orifice stenosis. Mean degree of stenosis was 70.45 +/- 7.455 percent and mean age was 71.65 +/- 7.743 years . In the 22 patients (22/43, 51.16%) stenosis were in left side. In the thirty patients (30/43, 69.6%) there was evidence of atherosclerotic disease in the internal carotid artery and in the 23% contra lateral vertebral artery was involved. There were five different cases with left renal artery stenosis especially in the men with left vertebral artery stenosis. Initial technical success rate was 100%. No cerebrovascular complications or embolic events occurred. Six months control angiography follow-up revealed one patient with stent occlusion and moderate (40%) restenosis in the another patient. According to our finding angioplasty and stenting for vertebral artery orifice stenosis is safe and effective. Patients with vertebral artery orifice disease frequently have coexistent atherosclerotic stenosis in the other major extracranial arteries including carotid and renal arteries.

Vasa vasorum of the intracranial arteries.

Most of the major extracranial arteries have vasa vasorum which play an important role in some pathological conditions. However, in the intracranial arteries, the existence of vasa vasorum and their pathological implication have not been adequately investigated. We examined the distribution and incidence of vasa vasorum in the major cerebral arteries and their relationships to certain clinical factors in 50 autopsy cases performed between 1987 and 1994. By light microscopy, vasa vasorum were found in 36 of 50 patients. Of 36 patients, vasa vasorum in 30 cases were localizedly observed in the tunica adventitia and the in other 6 were distributed in the tunica media accompanied by intramural haemorrhage. Existence of vasa vasorum was more common in the proximal arteries (vertebral, internal carotid, and basilar arteries) than in the distal arteries (middle cerebral and anterior cerebral arteries). Vasa vasorum were found more frequently in aged patients with severe atherosclerosis and those with cerebrovascular diseases. Our results indicated that intracranial vasa vasorum existed with a higher frequency in the tunica adventitia of the vertebral and internal cerebral arteries, and the incidence of vasa vasorum related to severity of atherosclerosis. The development of vasa vasorum in the tunica media may reflect some pathological changes of cerebral arteries.

81. The effects of extreme cold on major extracranial arteries: Khairy Samra, K. Wisniewska, and Irving S. Cooper (Department of Neurologic Surgery, St. Barnabas Hospital, Bronx, New York)

81. The effects of extreme cold on major extracranial arteries: Khairy Samra, K. Wisniewska, and Irving S. Cooper (Department of Neurologic Surgery, St. Barnabas Hospital, Bronx, New York)

Special problems associated with surgical and thrombolytic treatment of strokes.

IN RECENT years many new approaches to the treatment of cerebral infarction due to occlusive cerebral vascular disease have appeared. The most important of these have been anticoagulants, 1,2 fibrinolytic agents, 3-5 and surgical excision of occlusive lesions in the major extracranial arteries supplying the brain. 6-8 The previous hopeless, helpless attitude of the physician treating the stroke patient has, as a result, been replaced by enthusiasm for these as yet incompletely evaluated methods. In recent months this fervor has been further stimulated by the report of the President's Commission on Heart Disease, Cancer and Stroke. 9 This paper will describe special complications of surgical and thrombolytic procedures which deserve attention and present very recent advances in surgical concept and technique which promise to overcome areas of potential difficulty and to markedly improve present therapeutic results. 10,11 This report is based on an analysis of 97 operative procedures in the

THE EFFECTS OF EXTREME COLD ON MAJOR EXTRACRANIAL ARTERIES AND VEINS.

Extreme cold has been focally applied to major extracranial arteries and veins in the cat. Reversible slowing of circulation and vascular occlusion have been shown to occur from this application. Following rewarming no acute changes within the lumen of the blood vessels have been observed radiographically and permanent thrombosis does not result after freezing of segments up to 30 minutes. Possible uses for this modality in cerebrovascular surgery are discussed.

MODIFIED METHOD FOR PERCUTANEOUS BRACHIAL ANGIOGRAPHY.

Introduction Vascular surgical techniques have developed to the point that atherosclerotic stenosis and occlusion of the major extracranial arteries can be successfully relieved in a large number of individuals. 1 The proper application of such treatment and correlation with possible neurological benefits depend in a large part upon angiographic visualization of all extracranial arteries involved. Adequate initial clinical diagnosis and subsequent appraisal of the patient's clinical course demands demonstration of the entire intracranial vascular tree as well. It becomes imperative, therefore, that arteriographic techniques be devised which fully demonstrate both extracranial and intracranial vessels and meet as well the following desirable criteria: (1) an entirely percutaneous approach avoiding surgical cutdown and/or the technical difficulties and risks of arterial catheterization 2 ; (2) rapid easy needle insertion preferably at a distance from the diseased vessel 3 ; (3) reduction of the amount of contrast material used and the number of injections used to