The Experts below are selected from a list of 279 Experts worldwide ranked by ideXlab platform
Cameron G. Mcdougall - One of the best experts on this subject based on the ideXlab platform.
-
The road less traveled: transarterial embolization of dural arteriovenous fistulas via the Ascending Pharyngeal Artery
Journal of neurointerventional surgery, 2016Co-Authors: Bradley A. Gross, Felipe C. Albuquerque, Karam Moon, Cameron G. McdougallAbstract:Background With the introduction of Onyx, transarterial embolization has become the most common endovascular approach to treating dural arteriovenous fistulas (dAVFs), often via the middle meningeal or occipital arteries. The Ascending Pharyngeal Artery (APA) is a less frequently explored transarterial route because of its small caliber, potential anastomoses to the internal carotid and vertebral arteries, and vital supply to lower cranial nerves. Objective To review our institutional experience and highlight the prevalence of APA supply to dAVFs and cases where it is a safe and effective pedicle for embolization. Methods We reviewed our endovascular database (January 1, 1996 to March 1, 2016) for cranial dAVFs, evaluating dAVF characteristics and embolization results for those treated transarterially via the APA. Results Of 267 endovascularly treated dAVFs, 68 had APA supply (25%). Of these 68 dAVFs, embolization was carried out via this pedicle in 8 (12%) and 7 were ultimately occluded. No complications, including post-treatment cranial neuropathies or radiographic evidence of non-target embolization, were found. For 5 dAVFs, the APA was selected as the initial pedicle for embolization (two marginal sinus, one distal sigmoid, one cavernous, one tentorial). In four of these five cases, dAVF occlusion was achieved via the initial APA feeding Artery pedicle. In one case, near-complete, stagnant occlusion was achieved after APA embolization; complete occlusion was achieved after adjunctive embolization of a single additional middle meningeal Artery pedicle. In three other cases of complex transverse/sigmoid dAVFs, the APA was used after multiple attempts via middle meningeal and occipital Artery pedicles. Occlusion was not achieved transarterially; two of these three dAVFs were ultimately occluded transvenously. Conclusions In rare, select cases, the APA is an excellent route for transarterial embolization of cranial dAVFs.
Akira Uchino - One of the best experts on this subject based on the ideXlab platform.
-
Ascending Pharyngeal Artery–posterior inferior cerebellar Artery anastomosis via the jugular foramen: a case report and literature review
Surgical and Radiologic Anatomy, 2021Co-Authors: Akira Uchino, Hitoshi Ohno, Ryushi Kondo, Shoichiro IshiharaAbstract:The posterior inferior cerebellar Artery (PICA) rarely arises from the cavernous segment of the internal carotid Artery (ICA) and is called persistent trigeminal Artery variant. The PICA also can arise from the cervical segment of the ICA, and it enters the posterior fossa via the hypoglossal canal, where it is called persistent hypoglossal Artery variant. Using magnetic resonance angiography (MRA), we diagnosed a 79-year-old man with a PICA arising from the Ascending Pharyngeal Artery and passing through the medial side of the jugular foremen pars vascularis. Only six cases of this variation have been reported previously in the English language literature. To identify this variation on MRA, the careful observation of source images is useful. Recognizing this variation is important in order to avoid ischemic cerebellar complications during neck surgery and endovascular therapy.
-
Ascending Pharyngeal Artery-posterior inferior cerebellar Artery anastomosis via the jugular foramen: a case report and literature review.
Surgical and radiologic anatomy : SRA, 2021Co-Authors: Akira Uchino, Hitoshi Ohno, Ryushi Kondo, Shoichiro IshiharaAbstract:The posterior inferior cerebellar Artery (PICA) rarely arises from the cavernous segment of the internal carotid Artery (ICA) and is called persistent trigeminal Artery variant. The PICA also can arise from the cervical segment of the ICA, and it enters the posterior fossa via the hypoglossal canal, where it is called persistent hypoglossal Artery variant. Using magnetic resonance angiography (MRA), we diagnosed a 79-year-old man with a PICA arising from the Ascending Pharyngeal Artery and passing through the medial side of the jugular foremen pars vascularis. Only six cases of this variation have been reported previously in the English language literature. To identify this variation on MRA, the careful observation of source images is useful. Recognizing this variation is important in order to avoid ischemic cerebellar complications during neck surgery and endovascular therapy.
-
carotid Artery. Radiology 1973;106:567–73
2015Co-Authors: Akira UchinoAbstract:I readwith interest the article byChan et al.1 They stated that there was a rare congenital anastomosis between the vertebral Artery (VA) and internal carotid Artery (ICA) with an absence of communication between the common carotid and cervical ICA. I, however, diagnose that there was an acquired occlusion of the ICA at its origin with a development of collateral circulation from the VA to the ICA via the Ascending Pharyngeal Artery. I am very interested in the diagnosis of the cerebral arterial varia-tions.2 It is well known that the Ascending Pharyngeal Artery some-times arises from the proximal ICA.3 In the patient reported by Chan et al, the Ascending Pharyngeal Artery was well visualized, but opaci-fication of the ICA was faint and delayed. This suggests that there was not a direct anastomosis between the VA and ICA. In patients with congenital absence of the ICA, the common ca-rotid Artery and the proximal external carotid Artery are usually the same size. In the patient reported by Chan et al, the common carotid Artery was definitely larger than the proximal external carotid Artery. This fact suggests that therewas an acquired occlusion of the ICA at its origin
-
posterior inferior cerebellar Artery supplied by the jugular branch of the Ascending Pharyngeal Artery diagnosed by mr angiography report of two cases
The Cerebellum, 2011Co-Authors: Akira Uchino, Chihiro SuzukiAbstract:The posterior inferior cerebellar Artery (PICA) is extremely rarely supplied by the Artery passing through the hypoglossal canal. This anomalous Artery can arise from the cervical internal carotid Artery or Ascending Pharyngeal Artery (APA). We present what we believe is the first report of PICA supplied by the jugular branch of the APA that passes through the medial side of the jugular foramen pars vascularis, diagnosed using magnetic resonance angiography. To avoid ischemic brain complications during head and neck surgeries and interventional radiologic procedures, preoperative recognition of anomalously originating pial arteries from the APA is important.
-
Collateral circulation via the Ascending Pharyngeal Artery arising from the internal carotid Artery.
AJNR. American journal of neuroradiology, 2006Co-Authors: Akira UchinoAbstract:I read with interest the article by Chan et al.[1][1] They stated that there was a rare congenital anastomosis between the vertebral Artery (VA) and internal carotid Artery (ICA) with an absence of communication between the common carotid and cervical ICA. I, however, diagnose that there was an
Bradley A. Gross - One of the best experts on this subject based on the ideXlab platform.
-
The road less traveled: transarterial embolization of dural arteriovenous fistulas via the Ascending Pharyngeal Artery
Journal of neurointerventional surgery, 2016Co-Authors: Bradley A. Gross, Felipe C. Albuquerque, Karam Moon, Cameron G. McdougallAbstract:Background With the introduction of Onyx, transarterial embolization has become the most common endovascular approach to treating dural arteriovenous fistulas (dAVFs), often via the middle meningeal or occipital arteries. The Ascending Pharyngeal Artery (APA) is a less frequently explored transarterial route because of its small caliber, potential anastomoses to the internal carotid and vertebral arteries, and vital supply to lower cranial nerves. Objective To review our institutional experience and highlight the prevalence of APA supply to dAVFs and cases where it is a safe and effective pedicle for embolization. Methods We reviewed our endovascular database (January 1, 1996 to March 1, 2016) for cranial dAVFs, evaluating dAVF characteristics and embolization results for those treated transarterially via the APA. Results Of 267 endovascularly treated dAVFs, 68 had APA supply (25%). Of these 68 dAVFs, embolization was carried out via this pedicle in 8 (12%) and 7 were ultimately occluded. No complications, including post-treatment cranial neuropathies or radiographic evidence of non-target embolization, were found. For 5 dAVFs, the APA was selected as the initial pedicle for embolization (two marginal sinus, one distal sigmoid, one cavernous, one tentorial). In four of these five cases, dAVF occlusion was achieved via the initial APA feeding Artery pedicle. In one case, near-complete, stagnant occlusion was achieved after APA embolization; complete occlusion was achieved after adjunctive embolization of a single additional middle meningeal Artery pedicle. In three other cases of complex transverse/sigmoid dAVFs, the APA was used after multiple attempts via middle meningeal and occipital Artery pedicles. Occlusion was not achieved transarterially; two of these three dAVFs were ultimately occluded transvenously. Conclusions In rare, select cases, the APA is an excellent route for transarterial embolization of cranial dAVFs.
Gao Chen - One of the best experts on this subject based on the ideXlab platform.
-
transarterial embolization of cavernous sinus dural arteriovenous fistulas with ipsilateral inferior petrosal sinus occlusion via the Ascending Pharyngeal Artery
World Neurosurgery, 2018Co-Authors: Bing Fang, Cong Qian, Dingyao Jiang, Jianmin Zhang, Gao ChenAbstract:Background Although the ipsilateral inferior petrosal sinus (IPS) is preferred for treatment of cavernous sinus dural arteriovenous fistulas (CS-dAVFs), this method is problematic if ipsilateral IPS is occluded. We describe our experience in treating CS-dAVFs with ipsilateral IPS occlusion via the Ascending Pharyngeal Artery (APA). Methods Between January 2013 and June 2017, of 36 CS-dAVFs, 23 with ipsilateral IPS occlusion were identified. Clinical charts, procedural data, angiographic results, and follow-up data were retrospectively reviewed. Results Of 23 CS-dAVFs, 16 displayed a single or dominant feeding APA on cerebral angiography, of which 13 were treated via the APA initially. Fistulas were occluded successfully through the neuromeningeal trunk of the APA in 7 cases and through the superior Pharyngeal branch of the APA in 3 cases. Glue leakage occurred in 2 cases via the superior Pharyngeal branch of the APA, and superior Pharyngeal branch rupture occurred during superselection of the microguidewire in 1 patient, who was treated by opening the occluded ipsilateral IPS. During the follow-up period, 12 of 13 patients had complete occlusion, and no cranial nerve palsy occurred. Conclusions CS-dAVF with ipsilateral IPS occlusion can be treated via various methods. Embolization through the APA as an initial access is a reasonable choice.
Robert A. Van Hulst - One of the best experts on this subject based on the ideXlab platform.
-
Cerebral arterial gas embolism in swine. Comparison of two sites for air injection.
Journal of neuroscience methods, 2010Co-Authors: Robert P. Weenink, Markus W. Hollmann, Markus F. Stevens, Krijn P. Van Lienden, Elham Ghazi-hosseini, Thomas M. Van Gulik, Robert A. Van HulstAbstract:Abstract Cerebral arterial gas embolism is a risk in diving and occurs as a complication in surgery and interventional radiology. Swine models for cerebral arterial gas embolism have been used in the past. However, injection of air into the main Artery feeding the pig brain – the Ascending Pharyngeal Artery – might be complicated by the presence of the carotid rete, an arteriolar network at the base of the brain. On the other hand, anastomoses between external and internal carotid territories are present in the pig. In order to determine the most appropriate vessel for air injection, we performed experiments in which air was injected into either the Ascending Pharyngeal Artery or the external carotid Artery. We injected 0.25 ml/kg of room air selectively into the Ascending Pharyngeal Artery or the external carotid Artery of 35–40 kg Landrace pigs (n = 8). We assessed the effect on cerebral metabolism by measuring intracranial pressure, brain oxygen tension and brain glucose and lactate concentrations using cerebral microdialysis. Intracranial pressure and brain oxygen tension changed significantly in both groups, but did not differ between groups. Brain lactate increased significantly more in pigs in which air was injected into the Ascending Pharyngeal Artery. Intracranial pressure, brain oxygen tension and brain lactate correlated after injection of air into the Ascending Pharyngeal Artery, but not after injection into the external carotid Artery. Our model is suitable for investigation of cerebral arterial gas embolism. The Ascending Pharyngeal Artery is the most appropriate vessel for air injection.
