PT  - JOURNAL ARTICLE
AU  - Martin, Monty A.
AU  - Marotta, Tom R.
TI  - Vasa Vasorum: Another Cause of the Carotid String Sign
DP  - 1999 Feb 01
TA  - American Journal of Neuroradiology
PG  - 259--262
VI  - 20
IP  - 2
4099  - http://www.ajnr.org/content/20/2/259.short
4100  - http://www.ajnr.org/content/20/2/259.full
SO  - Am. J. Neuroradiol.1999 Feb 01; 20
AB  - BACKGROUND AND PURPOSE: Our purpose was to describe a variant of the carotid string sign that may be associated with a completely occluded vessel and to consider possible pathophysiological mechanisms for this observation.METHODS: Carotid angiography was performed in three patients with suspected carotid stenosis and in a fourth with carotid dissection. Surgery was performed in one of the patients with carotid stenosis.RESULTS: On all angiograms, instead of a single linear or curvilinear contrast “string,” either single or multiple serpiginous channels were seen. In one case, such a channel was seen emanating from below the origin of an occluded internal carotid stump, reconstituting the distal portion of the vessel. Surgery revealed a completely occluded lumen with a small intramural vessel bypassing the obstruction.CONCLUSION: We propose that these channels are either atherosclerotically induced neovessels connecting bridging vasa vasorum or recanalized luminal thrombus. We review the literature associated with this subject.