Rockley Mark, Ryan Stephen E, Nagpal Sudhir
Division of Vascular and Endovascular Surgery, Department of Surgery, University of Ottawa, The Ottawa Hospital-Civic Campus, Ottawa, Ontario, Canada.
Department of Medical Imaging, University of Ottawa, The Ottawa Hospital-Civic Campus, Ottawa, Ontario, Canada.
J Vasc Surg Cases Innov Tech. 2020 Sep 2;6(4):520-523. doi: 10.1016/j.jvscit.2020.08.007. eCollection 2020 Dec.
Presented is a patient with carotid artery stenosis resulting in crescendo anterior and posterior circulation transient ischemic attacks. Treatment was complicated by a rare persistent hypoglossal artery (HGA) arising from the left internal carotid artery in addition to severe contralateral carotid disease, hypoplastic vertebral arteries, and incomplete circle of Willis. A carotid endarterectomy with shunting was performed, maintaining perfusion of both the proper left internal carotid artery and HGA. This is a rare case of carotid stenosis in the setting of a persistent HGA with contralateral carotid disease and highlights the importance of planning intracranial perfusion before carotid surgery.
报告了一名患有颈动脉狭窄并导致进行性前循环和后循环短暂性脑缺血发作的患者。除了严重的对侧颈动脉疾病、椎动脉发育不全和Willis环不完整外，治疗还因左颈内动脉发出罕见的永存舌下动脉（HGA）而变得复杂。进行了带分流的颈动脉内膜切除术，维持了左颈内动脉固有分支和HGA的灌注。这是一例在存在永存HGA且伴有对侧颈动脉疾病情况下发生颈动脉狭窄的罕见病例，突出了颈动脉手术前规划颅内灌注的重要性。
