Posterior circulation stroke following embolization of glomus tympanicum?relevance of anatomy and anastomoses of ascending pharyngeal artery. A case report.
| Title: | Posterior circulation stroke following embolization of glomus tympanicum?relevance of anatomy and anastomoses of ascending pharyngeal artery. A case report. |
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| Authors: | Sawlani V; Morriston Hospital; Swansea, U.K. - vijaysawlani@hotmail.com.; Browing S; Sawhney IM; Redfern R |
| Source: | Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences [Interv Neuroradiol] 2009 Jul 29; Vol. 15 (2), pp. 229-36. Date of Electronic Publication: 2009 Sep 01. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Sage Publications Country of Publication: United States NLM ID: 9602695 Publication Model: Print-Electronic Cited Medium: Print ISSN: 1591-0199 (Print) Linking ISSN: 15910199 NLM ISO Abbreviation: Interv Neuroradiol Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Publication: 2015- : Thousand Oaks, CA : Sage Publications; Original Publication: Milan, Udine, Italy : Edizioni del Centauro, [1995- |
| Abstract: | Summary: Embolization in the territory of the ascending pharyngeal artery (APA) can be unsafe even after detailed pretherapeutic angiographic evaluation due to changes in haemodynamics and opening of anastomotic channels. A 60-year-old woman underwent angiogram and embolization for glomus tympanicum tumour. The glomus tympanicum tumour was embolized using contour PVA particles of 150-250 um. At the end of the particulate injection the patient had posterior circulation stroke. The check angiogram showed near total devascularisation of the tumour and in addition filling of the left vertebral artery through an anastomotic channel. MRI confirmed the infarct in the posterior circulation. The ascending pharyngeal artery has potential anastomoses to all neighbouring major arteries, and the anastomoses to the vertebral artery in our case were through the musculospinal artery. This case highlights the importance of potential vascular anastomotic channels as a cause of ischaemic complication during the embolization procedure. It also highlights the fact that dangerous anastomoses may only be visualised in the later phase of embolization probably due to changes in the haemodynamic pressure. The angiographic anatomy of APA is reviewed with potential communications with the internal and external carotid and vertebrobasilar systems. |
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| Entry Date(s): | Date Created: 20100515 Date Completed: 20121002 Latest Revision: 20211020 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC3299028 |
| DOI: | 10.1177/159101990901500216 |
| PMID: | 20465905 |
| Database: | MEDLINE |
Journal Article