Symptomatic vertebral artery (VA) stenosis associated with bilateral carotid rete mirabile (CRM) has not been reported. We report the long-term clinical and angiographic outcome after stenting for symptomatic VA stenosis in the patient with bilateral CRM. This report is the first case that symptomatic VA stenosis associated with bilateral CRM was treated with stenting.
Adult ; Angioplasty, Balloon ; Carotid Arteries/pathology/*radiography/*surgery ; Cerebral Angiography ; Female ; Humans ; *Stents ; Syncope/etiology ; Treatment Outcome ; Vertebrobasilar Insufficiency/*radiography/*surgery ; Young Adult

OBJECTIVETo study the diagnosis and treatment of the malignant tumor involving carotid artery.

METHODSA total of 23 cases of recurrent malignant tumors involving the carotid artery were included in this study. For the primary cancers, 8 of 23 cases were laryngeal carcinomas, 10 hypopharyngeal carcinomas, 2 thyroid carcinomas, 1 tonsil carcinoma, 1 parotid gland carcinoma, and 1 hypopharyngeal sarcoma with the invasion of cervical esophagus. Detailed evaluation on each case was performed before treatment. The relations of recurrent tumors with neck blood vessels were determined with enhanced CT/CTA. Of 23 cases with recurrent malignant tumors involving the carotid artery, 16 cases received surgery and 7 cases received the palliative treatment without operation.

RESULTSSeven patients with palliative treatments died of hemorrhage from the invaded neck blood vessels, systemic failure or pulmonary metastasis in six months. Of 16 cases with surgery, recurrent tumors were completely excised in 14 cases and there were residual tumor tissues on artery walls in 2 cases. Within 16 surgical cases, 2 cases died of neck hemorrhoea after one week because of infection, 2 cases died of lung metastasis 8 months later, 3 cases died of neck local recurrence 1 year later, 2 cases died of lung metastasis after 2 years, 1 case died of neck local recurrence 2 years later and 1 case died of a heart attack 2 years later. The rest 5 cases were alive.

CONCLUSIONSEnhancement CT/CTA can used in the evaluation for recurrent malignant tumors involving the carotid artery. Surgical treatments can be applied to some selected patients, which can improve the quality of life and survival time of the patients.

Aged ; Carotid Arteries ; pathology ; Female ; Head and Neck Neoplasms ; diagnostic imaging ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; pathology ; Radiography

Hypothermia and cardiopulmonary bypass has rarely been used for difficult lesions of the brain such as giant aneurysms and hemangioblastoma of the brainstem. We report a case of huge recurrent angioblastic meningioma operated under the profound hypothermia and cardiopulmonary bypass. We reviewed the complications related to hypothermia and cardiopulmonary bypass for brain lesions.
Adult ; Brain Neoplasms/*surgery ; Cardiopulmonary Bypass/*methods ; Carotid Arteries/pathology ; Carotid Artery Diseases/therapy ; Case Report ; Cerebral Angiography ; Embolization, Therapeutic ; Fatal Outcome ; Female ; Human ; Hypothermia, Induced/*methods ; Lung/pathology/radiography ; Magnetic Resonance Imaging ; Meningioma/*surgery ; Neoplasms, Second Primary/*surgery ; Recurrence