RT Journal Article SR Electronic T1 Double embolic protection during carotid artery stenting with persistent hypoglossal artery JF Journal of NeuroInterventional Surgery JO J NeuroIntervent Surg FD BMJ Publishing Group Ltd. SP e23 OP e23 DO 10.1136/neurintsurg-2013-010709.rep VO 6 IS 3 A1 Christine F Silva A1 Samuel Y Hou A1 Anna L Kühn A1 Richard H Whitten A1 Ajay K Wakhloo YR 2014 UL http://jnis.bmj.com/content/6/3/e23.abstract AB 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.