查看文章

A 62-year-old male patient was admitted to undergo aortic valve replacement surgery for severe aortic stenosis. As part of preoperative preparation, a computed tomography (CT) angiography showed occlusion of the right common carotid artery (CCA)(Figures 1 and 2) and the right internal carotid artery (ICA) at the origin with a poor retrograde filling of the C7, C6, and C5 segment (Figure 2). Also, there were occlusions of the left CCA (Figures 1 and 2) and the left ICA at the origin with a poor retrograde filling of the C7, C6, and C5 segment (Figure 2). The external carotid arteries were filled by collaterals (Figure 2). The right vertebral artery (VA) was occluded at its origin (Figures 1 and 2), with retrograde filling up to the mid-V2 segment. The Circle of Willis was normal, unchanged. Endocranial CT showed the existence of hypodense changes in white mass, primarily of chronic microischemic genesis.

The unique …