Treatment of internal carotid artery agenesis with intercavernous anastomosis (Lie’s type D anastomosis) by simple balloon dilatation

This article reports a rare vascular anomaly: internal carotid artery agenesis with intercavernous anastomosis (Lie's type D anastomosis). According to Digital Subtraction Angiography (DSA), the left common carotid artery (LCCA) continues as the external carotid artery (ECA), and no lumen arteriosclerosis or the origin of the internal carotid artery (ICA) is observed on the angiogram. The patient's left internal carotid artery (LICA) originated from the C6 segment of the right internal carotid artery and was compensated by it. At the same time, both the left middle cerebral artery(LMCA) and the anterior cerebral artery(ACA) originates from the right internal carotid artery (RICA) system. Severe stenosis at the beginning of LICA resulted in TIA in patients. After simple balloon dilation treatment, the patient showed favorable angioplasty and no further ischemic events occurred during a 1-year follow-up. Previous such studies have less experience with previous involvement. This article suggests that simple balloon dilation may effectively improve the prognosis of patients with vascular anomaly accompanied by severe stenosis, with low risk. This has certain teaching and clinical guidance value.