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- Publisher Website: 10.1016/j.jocn.2020.04.104
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Article: Vertebral-carotid bypass for common carotid artery occlusion
Title | Vertebral-carotid bypass for common carotid artery occlusion |
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Authors | |
Keywords | Aneurysm Intracranial Aneurysm Posterior cerebral |
Issue Date | 2020 |
Publisher | Churchill Livingstone. The Journal's web site is located at http://www.elsevier.com/locate/jocn |
Citation | Journal of Clinical Neuroscience, 2020, v. 78, p. 403-405 How to Cite? |
Abstract | One of the treatment options for long segment common carotid artery (CCA) occlusion is bypass surgery with different combinations of donors and receipts. Using vertebral artery (VA) as the donor for CCA occlusion was uncommonly reported. The reported cases were using jump graft to connect V3 segment of VA to either CCA or ICA. We describe our patient using V2 segment as the donor for VA-CCA bypass as treatment for CCA occlusion. Our patient was a 51 years old gentleman with Marfan syndrome and had multiple operations that included total arch replacement. He presented with sudden onset of spontaneous right frontal subarachnoid haemorrhage and repeated episodes of TIA with left upper limb numbness. CTA showed occluded right CCA and anastomosis between branches from subclavian artery and occipital artery. CT perfusion showed hypoperfusion of right hemisphere. To avoid damaging the anastomosis at subclavian artery and occipital artery, we decided for V2-RAG (radial artery graft)-CCA bypass. It was done by exposing the V2 segment at C4/5 level, performing end-to-side anastomoses at V2-RAG and RAG-CCA junctions where the RAG was underneath the internal jugular vein. Patient had no new deficits after surgery and no more TIAs. CTA performed one week after surgery showed patent RAG. In conclusion, using V2 for VA-CCA bypass is technically feasible and may have theoretical advantages over using V3. V2-CCA bypass is an option for CCA occlusion in very selected patients. |
Persistent Identifier | http://hdl.handle.net/10722/282533 |
ISSN | 2023 Impact Factor: 1.9 2023 SCImago Journal Rankings: 0.609 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Li, L-F | - |
dc.contributor.author | Tsang, FC-P | - |
dc.contributor.author | Cheng, KK-F | - |
dc.contributor.author | Lui, W-M | - |
dc.contributor.author | Tsang, AC-O | - |
dc.contributor.author | Leung, GK-K | - |
dc.date.accessioned | 2020-05-15T05:29:21Z | - |
dc.date.available | 2020-05-15T05:29:21Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | Journal of Clinical Neuroscience, 2020, v. 78, p. 403-405 | - |
dc.identifier.issn | 0967-5868 | - |
dc.identifier.uri | http://hdl.handle.net/10722/282533 | - |
dc.description.abstract | One of the treatment options for long segment common carotid artery (CCA) occlusion is bypass surgery with different combinations of donors and receipts. Using vertebral artery (VA) as the donor for CCA occlusion was uncommonly reported. The reported cases were using jump graft to connect V3 segment of VA to either CCA or ICA. We describe our patient using V2 segment as the donor for VA-CCA bypass as treatment for CCA occlusion. Our patient was a 51 years old gentleman with Marfan syndrome and had multiple operations that included total arch replacement. He presented with sudden onset of spontaneous right frontal subarachnoid haemorrhage and repeated episodes of TIA with left upper limb numbness. CTA showed occluded right CCA and anastomosis between branches from subclavian artery and occipital artery. CT perfusion showed hypoperfusion of right hemisphere. To avoid damaging the anastomosis at subclavian artery and occipital artery, we decided for V2-RAG (radial artery graft)-CCA bypass. It was done by exposing the V2 segment at C4/5 level, performing end-to-side anastomoses at V2-RAG and RAG-CCA junctions where the RAG was underneath the internal jugular vein. Patient had no new deficits after surgery and no more TIAs. CTA performed one week after surgery showed patent RAG. In conclusion, using V2 for VA-CCA bypass is technically feasible and may have theoretical advantages over using V3. V2-CCA bypass is an option for CCA occlusion in very selected patients. | - |
dc.language | eng | - |
dc.publisher | Churchill Livingstone. The Journal's web site is located at http://www.elsevier.com/locate/jocn | - |
dc.relation.ispartof | Journal of Clinical Neuroscience | - |
dc.subject | Aneurysm | - |
dc.subject | Intracranial Aneurysm | - |
dc.subject | Posterior cerebral | - |
dc.title | Vertebral-carotid bypass for common carotid artery occlusion | - |
dc.type | Article | - |
dc.identifier.email | Li, L-F: lfrandom@hku.hk | - |
dc.identifier.email | Tsang, FC-P: tcp199@hku.hk | - |
dc.identifier.email | Cheng, KK-F: kfckevin@hku.hk | - |
dc.identifier.email | Lui, W-M: mattlui@hku.hk | - |
dc.identifier.email | Tsang, AC-O: acotsang@hku.hk | - |
dc.identifier.email | Leung, GK-K: gkkleung@hku.hk | - |
dc.identifier.authority | Tsang, AC-O=rp01519 | - |
dc.identifier.authority | Leung, GK-K=rp00522 | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1016/j.jocn.2020.04.104 | - |
dc.identifier.scopus | eid_2-s2.0-85083590164 | - |
dc.identifier.hkuros | 309888 | - |
dc.identifier.volume | 78 | - |
dc.identifier.spage | 403 | - |
dc.identifier.epage | 405 | - |
dc.identifier.isi | WOS:000556833000071 | - |
dc.publisher.place | United Kingdom | - |
dc.identifier.issnl | 0967-5868 | - |