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Effect of vasa vasorum in cerebrovascular compensation: 2 case reports

Intracranial vasa vasorum (VV) are rare and develop predominantly in the proximal segments of the internal carotid artery (ICA) and vertebral artery (VA). The typical appearance of intracranial VV has not yet been reported in clinical practice. Although VV in the ICA have been found to re-institute...

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Autores principales: Wang, Rongfei, Weng, Luankun, Li, Mengzhen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7210153/
https://www.ncbi.nlm.nih.gov/pubmed/32395552
http://dx.doi.org/10.21037/atm.2020.03.77
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author Wang, Rongfei
Weng, Luankun
Li, Mengzhen
author_facet Wang, Rongfei
Weng, Luankun
Li, Mengzhen
author_sort Wang, Rongfei
collection PubMed
description Intracranial vasa vasorum (VV) are rare and develop predominantly in the proximal segments of the internal carotid artery (ICA) and vertebral artery (VA). The typical appearance of intracranial VV has not yet been reported in clinical practice. Although VV in the ICA have been found to re-institute the collateral flow, bypassing the obstructive segment, far less attention has been paid to the manner in which VV can connect the two ends of the obstructive segment through the plaque. In this study, we present two cases and discuss the positive effects of VV. In our first case, a patient with basilar artery (BA) occlusion and multiple infarcts in the posterior circulation territory received endovascular treatment. Digital subtraction angiography (DSA) showed the existence of VV, which originated from the proximal BA lumen, penetrated through the vessel wall, bypassed the obstructive segment, re-penetrated through the vessel wall, and reconnected to the distal BA lumen. Balloon angioplasty was performed, specifically avoiding the path of the VV, then the VV had disappeared in follow-up angiography. In our second case, a patient who had been diagnosed with occlusion in the initial segment of the left ICA two years ago suffered a stroke. DSA revealed that the VV collaterals penetrated directly through the plaque of obstructive site and reconnected to the distal vessel lumen, which caused low hemodynamic compensation. Angioplasty was performed directly following the VV path, then follow-up angiography showed the VV had disappeared. Arterial occlusion, including in the intracranial and extracranial artery, could trigger the occurrence of VV, which can improve downstream perfusion. VV also could play a role of signal light in endovascular treatment.
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spelling pubmed-72101532020-05-11 Effect of vasa vasorum in cerebrovascular compensation: 2 case reports Wang, Rongfei Weng, Luankun Li, Mengzhen Ann Transl Med Case Report Intracranial vasa vasorum (VV) are rare and develop predominantly in the proximal segments of the internal carotid artery (ICA) and vertebral artery (VA). The typical appearance of intracranial VV has not yet been reported in clinical practice. Although VV in the ICA have been found to re-institute the collateral flow, bypassing the obstructive segment, far less attention has been paid to the manner in which VV can connect the two ends of the obstructive segment through the plaque. In this study, we present two cases and discuss the positive effects of VV. In our first case, a patient with basilar artery (BA) occlusion and multiple infarcts in the posterior circulation territory received endovascular treatment. Digital subtraction angiography (DSA) showed the existence of VV, which originated from the proximal BA lumen, penetrated through the vessel wall, bypassed the obstructive segment, re-penetrated through the vessel wall, and reconnected to the distal BA lumen. Balloon angioplasty was performed, specifically avoiding the path of the VV, then the VV had disappeared in follow-up angiography. In our second case, a patient who had been diagnosed with occlusion in the initial segment of the left ICA two years ago suffered a stroke. DSA revealed that the VV collaterals penetrated directly through the plaque of obstructive site and reconnected to the distal vessel lumen, which caused low hemodynamic compensation. Angioplasty was performed directly following the VV path, then follow-up angiography showed the VV had disappeared. Arterial occlusion, including in the intracranial and extracranial artery, could trigger the occurrence of VV, which can improve downstream perfusion. VV also could play a role of signal light in endovascular treatment. AME Publishing Company 2020-04 /pmc/articles/PMC7210153/ /pubmed/32395552 http://dx.doi.org/10.21037/atm.2020.03.77 Text en 2020 Annals of Translational Medicine. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Case Report
Wang, Rongfei
Weng, Luankun
Li, Mengzhen
Effect of vasa vasorum in cerebrovascular compensation: 2 case reports
title Effect of vasa vasorum in cerebrovascular compensation: 2 case reports
title_full Effect of vasa vasorum in cerebrovascular compensation: 2 case reports
title_fullStr Effect of vasa vasorum in cerebrovascular compensation: 2 case reports
title_full_unstemmed Effect of vasa vasorum in cerebrovascular compensation: 2 case reports
title_short Effect of vasa vasorum in cerebrovascular compensation: 2 case reports
title_sort effect of vasa vasorum in cerebrovascular compensation: 2 case reports
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7210153/
https://www.ncbi.nlm.nih.gov/pubmed/32395552
http://dx.doi.org/10.21037/atm.2020.03.77
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