TY - JOUR
T1 - Percutaneous transluminal angioplasty for persistent primitive hypoglossal artery stenosis
T2 - illustrative case
AU - Iwaki, Katsuma
AU - Arimura, Koichi
AU - Fukuda, Shunichi
AU - Takagishi, Soh
AU - Kurogi, Ryota
AU - Nakamura, Kuniyuki
AU - Nakamizo, Akira
AU - Yoshimoto, Koji
N1 - Publisher Copyright:
© 2023 The authors.
PY - 2023/10
Y1 - 2023/10
N2 - BACKGROUND We report a case of symptomatic, progressive stenosis of a persistent primitive hypoglossal artery (PPHA), which was successfully treated with percutaneous transluminal angioplasty (PTA) of the origin of the PPHA. The PPHA is a type of carotid-basilar anastomosis with an incidence of 0.02% to 0.10%. It originates from the internal carotid artery (ICA), passes through the hypoglossal canal, and merges with the basilar artery. In many cases, the ipsilateral vertebral artery is hypoplastic; therefore, PPHA stenosis causes cerebral infarction in the posterior circulation territory, as in this case. OBSERVATIONS The patient’s right PPHA had severe and progressive stenosis; therefore, he experienced cerebral infarction despite medical treatment. Therefore, PTA for the stenosis was performed, which ceased the recurrence of cerebral infarction and dizziness by improving blood flow in the posterior circulation. LESSONS Several reports have described ICA stenosis accompanied by PPHA or PPHA stenosis in patients receiving endovascular treatments. Almost all cases were nonprogressive, and the treatment procedure was stenting. However, in our case, the PPHA stenosis was progressive, and we performed PTA because the patient experienced resistance to antiplatelet drugs and had poor collateral flow.
AB - BACKGROUND We report a case of symptomatic, progressive stenosis of a persistent primitive hypoglossal artery (PPHA), which was successfully treated with percutaneous transluminal angioplasty (PTA) of the origin of the PPHA. The PPHA is a type of carotid-basilar anastomosis with an incidence of 0.02% to 0.10%. It originates from the internal carotid artery (ICA), passes through the hypoglossal canal, and merges with the basilar artery. In many cases, the ipsilateral vertebral artery is hypoplastic; therefore, PPHA stenosis causes cerebral infarction in the posterior circulation territory, as in this case. OBSERVATIONS The patient’s right PPHA had severe and progressive stenosis; therefore, he experienced cerebral infarction despite medical treatment. Therefore, PTA for the stenosis was performed, which ceased the recurrence of cerebral infarction and dizziness by improving blood flow in the posterior circulation. LESSONS Several reports have described ICA stenosis accompanied by PPHA or PPHA stenosis in patients receiving endovascular treatments. Almost all cases were nonprogressive, and the treatment procedure was stenting. However, in our case, the PPHA stenosis was progressive, and we performed PTA because the patient experienced resistance to antiplatelet drugs and had poor collateral flow.
UR - http://www.scopus.com/inward/record.url?scp=85175199331&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85175199331&partnerID=8YFLogxK
U2 - 10.3171/CASE23427
DO - 10.3171/CASE23427
M3 - Article
AN - SCOPUS:85175199331
SN - 2694-1902
VL - 6
JO - Journal of Neurosurgery: Case Lessons
JF - Journal of Neurosurgery: Case Lessons
IS - 17
M1 - CASE23427
ER -