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Case report
Double embolic protection during carotid artery stenting with persistent hypoglossal artery
  1. Christine F Silva1,
  2. Samuel Y Hou1,
  3. Anna L Kühn1,
  4. Richard H Whitten2,
  5. Ajay K Wakhloo1
  1. 1Department of Radiology, Division Neuroimaging and Intervention, New England Center for Stroke Research, Worcester, Massachusetts, USA
  2. 2Department of Vascular Surgery, University of Massachusetts, Worcester, Massachusetts, USA
  1. Correspondence to Dr A K Wakhloo, Department of Radiology, Division Neuroimaging and Intervention, New England Center for Stroke Research, University of Massachusetts Medical School, 55 Lake Avenue North, SA-107Q, Worcester, MA 01545, USA; ajay.wakhloo{at}umassmemorial.org

Abstract

A woman presented with 75% stenosis of the right internal carotid artery (ICA) with extension to the origin of a persistent hypoglossal artery (PHA). The PHA is a rare fetal variant of carotid–basilar anastomosis that elevates the risk of ischemia and embolic infarction within the posterior cerebral circulation in patients with carotid disease proximal to the anastomosis. Our case is highly unique because of the extremely rare nature of the PHA with associated ICA stenosis that extended to the PHA. Additionally, a novel treatment approach was employed by stenting and angioplasty while protecting both the anterior and posterior cerebral circulations.

  • Atherosclerosis
  • Embolic
  • Intervention
  • Stent

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