Common carotid artery occlusion with patent internal and external carotid arteries: Diagnosis and surgical management

Belkin, Michael; Mackey, William C.; Pessin, Michael S.; Caplan, Louis R.; O’Donnell, Thomas F.

doi:10.1016/0741-5214(93)90672-9

Cited by 59 publications

(52 citation statements)

References 15 publications

(2 reference statements)

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“…3 However, several symptoms can occur, including hemispheric stroke, amaurosis fugax, and brain hypoperfusion. 2 To date, no consensus exists for treatment of asymptomatic patients, and decisions for treatment of symptomatic patients are controversial and made according to each case. 4…”

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confidence: 99%

Common Carotid Artery Occlusion: A Single-Center Experience in 40 Cases

et al. 2015

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artery occlusion (CCAO) has been little discussed in the literature compared with occlusion of the internal carotid artery (ICA). However, CCAO seems to be a different disease because of its presentation, treatment, and incidence.CCAO is diagnosed in approximately 3% of the symptomatic patients undergoing carotid angiography 1 and in only 1 to 5% of the patients with symptomatic cerebrovascular disease. 2,3 The development of exuberant collateral circulation and patency of the carotid bifurcation seems to protect against ischemic brain lesions. 3 However, several symptoms can occur, including hemispheric stroke, amaurosis fugax, and brain hypoperfusion. 2 To date, no consensus exists for treatment of asymptomatic patients, and decisions for treatment of symptomatic patients are controversial and made according to each case. 4The incidence of common carotid artery occlusion (CCAO) is approximately 3% in patients who undergo angiography for symptomatic cerebrovascular disease; however, few studies have reported on management of this condition. The objective of this article was to analyze risk factors, therapeutic options, and clinical benefits of surgical treatment at a hospital in the city of São Paulo, Brazil. Data were collected from medical records of 40 patients with CCAO who were treated from June 2002 to October 2013. Results were analyzed retrospectively. Most of the patients were men (63.0%), who were significantly younger than women. Most of the participants had hypertension (90.0%), and more than half had a history of smoking (52.5%). The mean number of coexisting comorbidities/risk factors was 2.9 AE 1.0. Half of our sample had ipsilateral patent internal and external carotid artery, and 32.5% presented with an occluded internal carotid artery and a patent external artery. Patients with both an internal and an external occluded carotid artery (12.5%) were significantly older. Contralateral arteriosclerosis was observed in 65% of the patients, mainly represented by 50 to 90% stenosis. Most patients were symptomatic (67.5%), and hemiparesis was the most common symptom (55.0%) found. Most (77.5%) of the patients underwent the medical treatment; one out of three endovascular approaches failed. During the mean follow-up of 55 AE 43 months (range, 2-136 months), 17.5% of the patients died within 4 days after surgical repair and after along 123 months of clinical follow-up. Coexisting comorbidities/risk factors were significantly associated with fatal outcomes, such as acute myocardial infarction. This study provides scientific evidences on treatment and outcomes of CCAO.

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confidence: 99%

Common Carotid Artery Occlusion: A Single-Center Experience in 40 Cases

et al. 2015

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“…The extra cranial collateral vessels fill the ECA in a retrograde manner and maintain the anterograde flow in the ICA. The extra cranial collateral flow originates from the ipsilateral subclavian artery via the costocervical or thyrocervical trunks and the vertebral artery and, to a lesser degree, from the contralateral ECA through the superior thyroid and lingual, facial, and occipital branches [4,5,6]. The flow is maintained intracranially through the circle of Willis via the anterior and posterior communicating arteries.…”

Section: Discussion and Reviewmentioning

confidence: 99%

A Complete Occlusion of Common Carotid Artery- A Case Report

2016

IJSR

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This case report describes imaging in a patient with a complete occlusion of left common carotid artery after automobile accident. There were associated findings of collaterals that supply the pattern distal ipsilateral arteries. There were found no sign of stroke. The girl was suffering problems of loose of hearing from right ear and partial facial nerve paralyzes. No specific treatment was applied to this patient except the continuing follow -up.

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“…[3][4][5][6][7][8][9]12 Bypass to the external carotid artery has been performed using the contralateral common carotid artery or the aortic arch as an in-flow source. 10 The most common inflow source is the ipsilateral subclavian artery.…”

Section: Discussionmentioning

confidence: 99%

Staged Cerebral Revascularization in a Patient With an Occluded Common Carotid Artery

Rabb

Moneta

2005

Stroke

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Background and Purpose-We report a management strategy for cerebral revascularization in a patient with an occluded common carotid artery by first performing a subclavian to external carotid artery bypass, followed by superficial temporal artery middle cerebral artery (STA-MCA) bypass. Methods-The patient presented with symptomatic left hemispheric hemodynamic insufficiency, associated with occlusion of the ipsilateral internal and common carotid arteries. The STA was not detectable. The patient was treated initially with a subclavian to external carotid artery bypass, with partial improvement in symptoms. Results-Angiography demonstrated improvement in perfusion and STA filling, which was used for STA-MCA bypass, with resolution of symptoms. Conclusion-Our experience with this case has led us to consider a staged approach for management of patients with an occluded common carotid artery. (Stroke. 2005;36:e68-e70.)

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Common carotid artery occlusion with patent internal and external carotid arteries: Diagnosis and surgical management

Cited by 59 publications

References 15 publications

Common Carotid Artery Occlusion: A Single-Center Experience in 40 Cases

Common Carotid Artery Occlusion: A Single-Center Experience in 40 Cases

A Complete Occlusion of Common Carotid Artery- A Case Report

Staged Cerebral Revascularization in a Patient With an Occluded Common Carotid Artery

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