Thyrocervical trunk–external carotid artery bypass for positional cerebral ischemia due to common carotid artery occlusion: Report of three cases
Open accessAbstract
Medically refractory positional cerebral ischemia and concomitant orthostatic hypotension associated with chronic common carotid artery (CCA) occlusion are rare. The authors detail their experience with three cases treated exclusively by an extracranial bypass in which the thyrocervical trunk was used as the donor vessel. Postoperatively grafts were patent and symptoms resolved in all three patients, although orthostatic hypotension remained. Postural cerebral ischemia due to CCA occlusion can be treated by extracranial bypass surgery. The thyrocervical trunk is a suitable donor for reconstruction of the external carotid artery in these cases.
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Orthostatic TIAs concern a combination of multiple stenoses of cerebral arteries and OH, and may rarely result in repetitive, orthostatic, short-lasting, and stereotyped TIAs.
“An exception concerns orthostatic TIAs , concerning a combination of multiple stenoses of cerebral arteries and OH. This may rarely result in repetitive, orthostatic, short-lasting, and stereotyped TIAs.”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [423]
The Abstract describes rare positional cerebral ischemia with coexisting orthostatic hypotension, and Case 1 reports repetitive, brief episodes upon standing. But the Abstract says positional ischemia can occur with or without orthostatic hypotension and associates it with stenosis or occlusion of a major artery, not necessarily multiple cerebral-artery stenoses. (LLM, conf=0.86)
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References 29 · Cited by 10
- Authors
- Melgar, M. A., & Weinand, M. E.
- Affiliations
- University of Arizona (US)
- ORCID
- Weinand, Martin E.
- Venue
- Neurosurgical FOCUS
- Published
- 2003-03
- Volume
- 14
- Issue
- 3
- Pages
- 1-6
- ISSN
- 1092-0684 (ISSN-L)
- OpenAlex
- W1973130976
- Cited by
- 10
- References
- 29
- Citations by year
- 2024: 1 · 2022: 1 · 2020: 1 · 2018: 1 · 2015: 2 · 2014: 1 · 2013: 2
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Neurosurgical FOCUS (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cerebrovascular and Carotid Artery Diseases
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
- Keywords
- common carotid artery occlusion, thyrocervical trunk, external carotid artery, orthostatic hypotension, carotid artery reconstruction
- MeSH terms
- Aged, Anticoagulants, Arterial Occlusive Diseases, Carotid Artery Diseases, Carotid Artery, External, Cerebral Angiography, Ischemic Attack, Transient, Cerebral Revascularization, Dizziness, Ephedrine, Fludrocortisone, Humans, Hypotension, Orthostatic, Middle Aged, Paresis, Posture, Vision Disorders, Warfarin, Tomography, Emission-Computed, Single-Photon, Carotid Artery, Common
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