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lüll Vasa vasorum: another cause of the carotid string sign Martin MA; Marotta TRAJNR Am J Neuroradiol 1999[Feb]; 20 (2): 259-62BACKGROUND 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.|Aged[MESH]|Aneurysm/diagnostic imaging[MESH]|Carotid Arteries/*diagnostic imaging[MESH]|Carotid Artery Diseases/diagnostic imaging[MESH]|Carotid Stenosis/*diagnostic imaging[MESH]|Cerebral Angiography[MESH]|Diagnosis, Differential[MESH]|Female[MESH]|Humans[MESH]|Male[MESH]|Middle Aged[MESH]|Vasa Vasorum/*diagnostic imaging[MESH] |