{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T01:00:42Z","timestamp":1790125242488,"version":"4.0.1"},"reference-count":11,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"12","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,9,21]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Transcarotid transcatheter aortic valve implantation (TC-TAVI) is an alternative access route for patients in whom transfemoral TAVI is not suitable. Although carotid complications are uncommon, they may occur because of direct carotid manipulation. We report a rare case of acute common carotid artery occlusion after TC-TAVI treated with hybrid revascularization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 94-year-old woman underwent TC-TAVI through the left common carotid artery because severe iliofemoral calcification precluded transfemoral access. After the procedure, delayed emergence from general anesthesia, aphasia, and right hemiparesis developed. MRI demonstrated scattered infarctions in the left middle cerebral artery territory, and CT angiography revealed left common carotid artery occlusion. The mechanism and extent of the lesion could not be adequately determined preoperatively. Potential etiologies included repair site stenosis, thrombotic occlusion, and carotid dissection. Therefore, hybrid surgery was selected. Direct inspection revealed localized posterior wall intimal injury associated with subintimal hematoma and thrombus formation. Thrombectomy and intimal resection achieved complete recanalization with neurological improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Acute common carotid artery occlusion is a rare but potentially devastating complication of TC-TAVI. Careful patient selection for transcarotid access is essential. When the mechanism and extent of carotid occlusion cannot be adequately defined preoperatively, hybrid surgery may provide definitive diagnosis and safe revascularization.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE26527\">https:\/\/thejns.org\/doi\/10.3171\/CASE26527<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case26527","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:30Z","timestamp":1789516830000},"source":"Crossref","is-referenced-by-count":0,"title":["Hybrid revascularization for acute common carotid artery occlusion after transcarotid transcatheter aortic valve implantation: illustrative case"],"prefix":"10.3171","volume":"12","author":[{"given":"Ryo","family":"Yamamoto","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Ichinomiya Municipal Hospital, Ichinomiya, Aichi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Takayanagi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ichinomiya Municipal Hospital, Ichinomiya, Aichi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jungsu","family":"Choo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ichinomiya Municipal Hospital, Ichinomiya, Aichi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Tashiro","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ichinomiya Municipal Hospital, Ichinomiya, Aichi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsukasa","family":"Ohno","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Ichinomiya Municipal Hospital, Ichinomiya, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kotona","family":"Nomura","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ichinomiya Municipal Hospital, Ichinomiya, Aichi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keita","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ichinomiya Municipal Hospital, Ichinomiya, Aichi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daimon","family":"Shiraishi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ichinomiya Municipal Hospital, Ichinomiya, Aichi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Yamanouchi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ichinomiya Municipal Hospital, Ichinomiya, Aichi"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"5","key":"bib1","series-title":"Ann Thorac Surg","first-page":"1489","article-title":"Transcutaneous aortic valve implantation using the left carotid access: feasibility and early \u00adclinical outcomes","volume":"93","author":"Modine","year":"2012","unstructured":"Modine TSudre ADelhaye CTranscutaneous aortic valve implantation using the left carotid access: feasibility and early \u00adclinical outcomes. Ann Thorac Surg. 2012;93(5):1489-1494. doi:10.1016\/j.athoracsur.2012.01.030"},{"issue":"5","key":"bib2","series-title":"JACC Cardiovasc Interv","first-page":"472","article-title":"Transcarotid transcatheter aortic valve replacement: feasibility and safety","volume":"9","author":"Mylotte","year":"2016","unstructured":"Mylotte DSudre ATeiger ETranscarotid transcatheter aortic valve replacement: feasibility and safety. JACC Cardiovasc Interv. 2016;9(5):472-480. doi:10.1016\/j.jcin.2015.11.045"},{"issue":"5","key":"bib3","series-title":"JACC Cardiovasc Interv","first-page":"413","article-title":"Transcarotid approach for transcatheter aortic valve replacement with the Sapien 3 \u00adprosthes","volume":"12","author":"Overtchouk","year":"2019","unstructured":"Overtchouk PFolliguet TPinaud FTranscarotid approach for transcatheter aortic valve replacement with the Sapien 3 \u00adprosthesis: a multicenter French registry. JACC Cardiovasc Interv. 2019;12(5):413-419. doi:10.1016\/j.jcin.2018.11.014"},{"key":"bib4","series-title":"Int J Cardiol","first-page":"90","article-title":"Transcarotid transcatheter aortic valve implantation: a systematic review","volume":"262","author":"Wee","year":"2018","unstructured":"Wee IJYSyn NChoong AMTL.Transcarotid transcatheter aortic valve implantation: a systematic review. Int J Cardiol. 2018;262:90-95. doi:10.1016\/j.jjcc.2018.01.010"},{"issue":"7","key":"bib5","series-title":"J Am Coll Cardiol","first-page":"673","article-title":"Predictors of early cerebrovascular events in patients with aortic stenosis undergoing transcatheter aortic valve replacement","volume":"68","author":"Auffret","year":"2016","unstructured":"Auffret VRegueiro ADel Trigo MPredictors of early cerebrovascular events in patients with aortic stenosis undergoing transcatheter aortic valve replacement. J Am Coll Cardiol. 2016;68(7):673-684. doi:10.1016\/j.jacc.2016.05.065"},{"key":"bib6","series-title":"Circulation","first-page":"870","volume":"121","author":"Kahlert","year":"2010","unstructured":"Kahlert PAl-Rashid FD\u00f6ttger PCirculation. 2010;121:870-878. doi:10.1161\/CIRCULATIONAHA.109.855866"},{"issue":"10","key":"bib7","series-title":"Am J Cardiol","first-page":"1519","article-title":"Neurologic complications of unprotected transcatheter aortic valve implantation (from the Neuro-TAVI Trial)","volume":"118","author":"Lansky","year":"2016","unstructured":"Lansky AJBrown DPena CNeurologic complications of unprotected transcatheter aortic valve implantation (from the Neuro-TAVI Trial). 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N Engl J Med. 2001;344(12):898-906. doi:10.1056\/NEJM200103223441206"}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/12\/12\/article-CASE26527.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/12\/12\/article-CASE26527.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/12\/12\/article-CASE26527.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:02:25Z","timestamp":1790121745000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/12\/12\/article-CASE26527.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,21]]},"references-count":11,"journal-issue":{"issue":"12"},"URL":"https:\/\/doi.org\/10.3171\/case26527","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,21]]}}}