Common Carotid Artery Occlusion: A Case Series

Abstract

Subjects and Methods. We analysed 5000 cerebrovascular ultrasound records. A total of 0.4% of the patients had common carotid artery occlusion (CCAO). Results. The mean age was 59.8 ± 14.2 years, and the male/female ratio was 2.33. The most frequent risk factors were hypertension, ischaemic heart disease, dyslipidemia, diabetes mellitus, and smoking. Right-sided and left-sided CCAO occurred in 65% and 30% of the cases, respectively, and bilateral occlusion was detected in one case (5%). Patent bifurcation was observed in 10 cases of CCAO in which the anterograde flow in the ICA was maintained from the external carotid artery with reversed flow. In two of the cases, the occluded CCA was hypoplastic. The aetiology of CCAO in the majority of cases was the atherosclerosis (15 cases). The male/female ratio was higher in the patients with occluded distal vessels, and the short-term outcome was poorer. Only two cases from this series underwent revascularisation surgery. Spontaneous recanalisation was observed in one case. Conclusions. The most frequent cause of CCAO was atherosclerosis. The outcome is improved in the cases with patent distal vessels, and spontaneous recanalisation is possible. Treatment methods have not been standardised. Surgical revascularisation is possible in cases of patent distal vessels, but the indications are debatable.

Adaptation of the cerebrocortical circulation to carotid artery occlusion involves blood flow redistribution between cortical regions and is independent of eNOS

“…Cerebral ischemia is among the most common causes of death: it contributes to 87% of all strokes (36), and ϳ30% of strokes are caused by occlusive diseases of the carotid arteries (20). The overwhelming majority involve the occlusion of the internal carotid arteries (ICA), but the occlusion of the common carotid artery (CCA) is also responsible for ϳ0.2-5.0% of stroke cases (1). The pathological mechanisms that can lead to either gradual or sudden carotid artery occlusion include atherosclerosis, thrombosis superimposed on the atherosclerotic plaque, and carotid artery dissection.…”

Evaluation of revascularization after total arch replacement in common carotid artery occlusion

“…Although most patients with patent bifurcation presented with amaurosis fugax and vertigo attacks, no patients with patent distal vessels and well-functioning intracranial collaterals had a major stroke. They had what was defined as a combination of a disturbance in consciousness and at least two neurological signs (conjugate deviation, homonymous hemianopia, aphasia, and hemiplegia)[ 5 ]. In our case, hemiplegia was caused by a major stroke, which was associated with plaque of the shaggy aorta perioperatively.…”

“…In the latter, color flow duplex examination detects emboli and the patency of the distal vessels. Recognizing the patency of the distal vessels is important because it may allow for effective surgical revascularization when treating CCAO[ 5 ].…”

A Complete Occlusion of Common Carotid Artery- A Case Report

“…However, noninvasive duplex sonography, CT angiography, and MR angiography have partially replaced arteriography in daily diagnostication practice. The accuracy of duplex sonography should be much higher in the diagnosis of CCA obstruction compared to ICA occlusion due to accessibility of the CCA [3,8,9,10]. Arteriography has several limitations in cases of completely occluded CCA because of inadequate concentrations of contrast medium, variable collateral circulation, minimal flow in the distal branches, and poor delayed images [11,12 ,].…”