We report a very rare case of internal carotid artery (ICA) stenosis associated with
persistent primitive hypoglossal artery (PPHA) treated by stenting using a proximal
flow blockade and distal filter protection system. A 77-year-old man with a medical
history of repeated cerebral infarction was referred to our hospital for treatment
of progressive ICA stenosis. Cerebral angiography revealed that the degree of stenosis
was 50% and the PPHA branched just distal to the stenosis at the C2 vertebral level.
Black-blood magnetic resonance imaging indicated vulnerable plaque. The stenosis was
at a high location, so carotid artery stenting was employed. Under the proximal flow
blockade system with occlusion of the external and common carotid artery, distal filter
protection was placed in the ICA to prevent distal embolization. A self-expanding
stent was successfully deployed and the patient was discharged without any neurological
deficits. In stenting for the ICA stenosis associated with PPHA, the combination of
a proximal flow blockade and distal protection system is reasonable and safe.
Key Words
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Article info
Publication history
Published online: April 19, 2016
Accepted:
March 15,
2016
Received:
February 9,
2016
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.03.026
Copyright
© 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.
