Abstract:

Objective

To analyze the clinical features and surgical protocol of a patient with human immunodeficiency virus （HIV） infection and symptomatic chronic internal carotid artery occlusion （CICAO），and to improve the clinical attention of patients with CICAO complicated with HIV infection.

Methods

The clinical data and surgical procedures of a patient with HIV infection and complicated with CICAO admitted to Beijing Ditan Hospital， Capital Medical University in September 2020 were analyzed， retrospectively； and the relevant literatures were reviewed.

Results

A 41 year-old male， presented clinically with hemiplegia of the left limb， and lacunar cerebral infarction appeared intermittently after the onset. The patient had been infected with HIV for 12 years， and anti-retrovirus therapy （ART） therapy was started one year before the onset. Cervical ultrasound indicated right internal carotid artery occlusion. After admission to our hospital， magnetic resonance imaging （MRI）， computed tomography perfusion imaging （CTP）， and digital subtraction angiography （DSA）examinations were performed and “CICAO” was confirmed. Superficial temporal artery frontal branch-middle cerebral artery （STA-MCA） bypass combined with STA parietal branch application was performed. The patient’s neurological function was partially recovered after surgery without recurrence of cerebral infarction.

Conclusions

HIV infection may accelerate the process of intracranial atherosclerosis. For patients with symptomatic CICAO，STA-MCA bypass combined with STA parietal branch application can increase cerebral perfusion， improve nerve function and prevent recurrence of ipsilateral stroke， which is an effective treatment option.

Key words: Chronic internal carotid artery occlusion, Human immunodeficiency virus, Bypass, Synangiosis