PMC6311804_01
CT angiogram head and neck. Note the occlusion of the left internal carotid artery, starting at the level of the common carotid bifurcation (a), in the neck (b), and in the carotid canal (c).
CRINM2018-9281918.001.jpg
PMC6311804_01_CRINM2018-9281918.001.jpg
fig1
CT angiogram of the head and neck was done and revealed occlusion of his left internal carotid artery, poor opacification of the left ophthalmic artery, and the presence of good collateral flow from the left posterior cerebral artery and the anterior communicating artery (Figures 1 and 2).
CT angiogram head and neck (continued): note the absence of the left internal carotid artery intracranially and poor opacification of the left ophthalmic artery. There is collateral supply to the left middle cerebral artery from the left posterior cerebral artery (a) and the anterior communicating artery (b). An intact circle of Willis allowed the left middle cerebral artery to maintain supply despite the complete occlusion of the left internal carotid artery.
CRINM2018-9281918.002.jpg
PMC6311804_01_CRINM2018-9281918.002.jpg
fig2
CT angiogram of the head and neck was done and revealed occlusion of his left internal carotid artery, poor opacification of the left ophthalmic artery, and the presence of good collateral flow from the left posterior cerebral artery and the anterior communicating artery (Figures 1 and 2).
Right lower extremity angiogram demonstrating acute occlusion of the distal popliteal artery with no significant runoff vessels. A catheter was placed in this artery and Tissue Plasminogen Activator (TPA) was infused overnight. Subsequent evaluation revealed resolution of thrombus within the popliteal artery and tibioperoneal trunk.
CRINM2018-9281918.003.jpg
PMC6311804_01_CRINM2018-9281918.003.jpg
fig3