RT Journal Article SR Electronic T1 Vasa Vasorum: Another Cause of the Carotid String Sign JF American Journal of Neuroradiology JO Am. J. Neuroradiol. FD American Society of Neuroradiology SP 259 OP 262 VO 20 IS 2 A1 Monty A. Martin A1 Tom R. Marotta YR 1999 UL http://www.ajnr.org/content/20/2/259.abstract 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.