+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Localized Marked Elongation of the Distal Internal Carotid Artery with or without PHACE Syndrome: Segmental Dolichoectasia of the Distal Internal Carotid Artery



Localized Marked Elongation of the Distal Internal Carotid Artery with or without PHACE Syndrome: Segmental Dolichoectasia of the Distal Internal Carotid Artery



Ajnr. American Journal of Neuroradiology 39(5): 817-823



Segmental intracranial dolichoectasia of the distal ICA is a feature of PHACE syndrome or a sporadic phenomenon. We evaluated the relationship between intracranial dolichoectasia of the distal ICA and PHACE syndrome and illustrated the characteristic radiologic findings of the lesions. Intracranial dolichoectasia of the distal ICA was identified in 20 patients at our institution from 2005 to 2016 through a review of diagnostic cerebral angiography results. All radiologic images were reviewed to determine the vascular morphologic dispositions around the distal ICA, including dysplasia, mural calcification, vessel wall enhancement, lumen narrowing, and aneurysm formation. Medical records were reviewed to determine the symptoms of PHACE syndrome. Subsequently, the correlation between radiologic findings and PHACE syndrome was assessed. In this cohort, which had a strong female predominance (male/female ratio= 2:18), intracranial dolichoectasia had a more ipsilateral vascular morphologic disposition. Mural calcification was detected more frequently in elderly patients, whereas vessel wall enhancement was detected more frequently in younger patients. Follow-up images showed a slow progression of the lesions. However, no significant differences in the vascular morphologic disposition and brain structural changes were observed between patients with (n = 11) and without (n = 9) PHACE syndrome. The striking elongation and tortuosity of the distal ICA generally appeared to be a type of congenital lesion occurring early in embryogenesis as either a sporadic phenomenon or an arterial change associated with PHACE syndrome. Imaging findings revealed various mural abnormalities with a benign clinical course.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 065284609

Download citation: RISBibTeXText

PMID: 29545249

DOI: 10.3174/ajnr.a5573


Related references

Giant internal carotid aneurysm distal occlusion of the internal carotid artery during carotid angiography a case. Neurologia Medico-Chirurgica 23(12): 972-975, 1983

Segmental agenesis of the internal carotid artery distal to the posterior communicating artery leading to the definition of a new embryologic segment. Ajnr. American Journal of Neuroradiology 25(7): 1189-1193, 2004

Stroke associated with elongation and kinking of the internal carotid artery: report of three cases treated by segmental resection of the carotid artery. Annals of Surgery 150: 824-832, 1959

Endarterectomy for Internal Carotid Artery Occlusion, with an Aberrant Branch of the Internal Carotid Artery Maintaining Blood Flow Distal to the Complete Occlusion:A Case Report. No Shinkei Geka. Neurological Surgery 46(1): 41-45, 2018

Skull base resection with cervical-to-petrous carotid artery bypass to facilitate repair of distal internal carotid artery lesions. Cardiovascular Surgery 10(1): 31-37, 2002

Devices and methods for preventing distal embolization from the internal carotid artery using flow reversal by partial occlusion of the external carotid artery. Official Gazette of the United States Patent & Trademark Office Patents 1240(2), Nov 14, 2000

Evaluation of distal extracranial internal carotid artery by transoral carotid ultrasonography in patients with severe carotid stenosis. Ajnr. American Journal of Neuroradiology 23(6): 924-928, 2002

A quantification of distal internal carotid artery diameter reduction due to increased narrowing of the artery Observations from the North American Symptomatic Carotid Endoarterectomy Trial. Stroke 29(1): 310, 1998

Distal internal carotid artery dissection due to the carotid shunt during carotid endarterectomy. British Journal of Neurosurgery 29(6): 862-864, 2016

Blood flow changes caused by distal filter protection and catheter aspiration in the internal carotid artery during carotid stenting: evaluation using carotid Doppler sonography. Ajnr. American Journal of Neuroradiology 32(2): 288-293, 2011

Emergent surgical embolectomy in conjunction with cervical internal carotid ligation and superficial temporal artery-middle cerebral artery bypass to treat acute tandem internal carotid and middle cerebral artery occlusion due to cervical internal carotid artery dissection. Surgical Neurology International 6: 191, 2016

Carotid endarterectomy when the distal internal carotid artery is small or poorly visualized. Journal Of Vascular Surgery. : 23-31, 1994

Air in the carotid canal as a predictor of distal internal carotid artery laceration. Acta Neurochirurgica 148(11): 1201-3; Discussion 1203, 2006

Regarding "Mandibular subluxation stabilized by mouthpiece for distal internal carotid artery exposure in carotid endarterectomy". Journal of Vascular Surgery 53(3): 883; Author Reply 883-4, 2011

Mandibular subluxation stabilized by mouthpiece for distal internal carotid artery exposure in carotid endarterectomy. Journal of Vascular Surgery 52(5): 1401-1404, 2010