Wesley P. Thayer, MD, PhD, John R. Gaughen, MD, Nancy L. Harthun, MD

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Presentation transcript:

Surgical revascularization in the presence of a preserved primitive carotid-basilar communication Wesley P. Thayer, MD, PhD, John R. Gaughen, MD, Nancy L. Harthun, MD Journal of Vascular Surgery Volume 41, Issue 6, Pages 1066-1069 (June 2005) DOI: 10.1016/j.jvs.2005.03.004 Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 1 Conceptual schematic drawing of the anterior (shaded) and posterior (open) cerebral circulation demonstrates the anastomoses between the two systems that are present in the 4- to 5-mm embryo. The represented aortic arches are those present in a 6-week-old embryo that continue to develop into the internal and common carotid arteries (third arch), part of the adult aortic arch (fourth arch), and proximal descending aorta (sixth arch). Adapted from Ouriel et al.1 Journal of Vascular Surgery 2005 41, 1066-1069DOI: (10.1016/j.jvs.2005.03.004) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 2 Arteriogram of a persistent left-sided hypoglossal artery (HA, arrow) arising from the common carotid artery (CCA) to supply the hindbrain. Note the location of the internal carotid artery (ICA) and external carotid artery (ECA). Journal of Vascular Surgery 2005 41, 1066-1069DOI: (10.1016/j.jvs.2005.03.004) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 3 Intracranial arteriography (anterior views) after injection into the (a) right and (b) left common carotid artery. Note the basilar artery (BA) and entire posterior system are dependent on flow from the left common carotid artery via the hypoglossal artery (HA). ICA, Internal carotid artery. Journal of Vascular Surgery 2005 41, 1066-1069DOI: (10.1016/j.jvs.2005.03.004) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 4 Intraoperative pictures demonstrate (A) a preserved hypoglossal artery (arrow) and (B) patch repair after carotid endarterectomy extending from the common carotid artery (CCA) onto the internal carotid artery. ECA, external carotid artery. Journal of Vascular Surgery 2005 41, 1066-1069DOI: (10.1016/j.jvs.2005.03.004) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions