Occlusion of the Internal Carotid Artery

Hp, Adams

doi:10.1001/jama.280.12.1093

Cited by 18 publications

(11 citation statements)

References 11 publications

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“…The reduced metabolite NAA suggests the neurons were lost or functional in the lateral of occluded vessel [19]. It implies that conservative treatment alone may not suitable for the subgroup patients [20]. Recently, extracranialintracranial (EC-IC) bypass trial showed benefit to the patients with impaired hemodynamics [21,22], which is contrast to the result of a randomized EC-IC bypass trial [6].…”

Section: Discussionmentioning

confidence: 99%

Angioplasty and stenting for the occluded internal carotid artery

Yue

Liu

et al. 2010

J Thromb Thrombolysis

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To investigate the feasibility and efficacy of angioplasty and stenting for symptomatic occlusion of carotid artery. From December 2004 to June 2009, 17 patients with progressive or reoccurred ischemic stroke or repeated transient ischemic attack resulted from the total occluded carotid artery underwent angioplasty and stenting were reviewed. All patients with successful procedure were followed up. Clinic and angiography data were documented prospectively. The median time from symptoms onset to procedure was 23 days (range 3-94 days). Twelve of the 17 patients (70%) were obtained technique success. Eight patients were observed the collapse of internal carotid artery between occluded location to origin of ophthalmic artery after the occlusion was patent. Two patients had clots which were solved with urokinase. The collapsed internal carotid artery was improved markedly in the compute tomography angiograph 7 days after the procedure. No any complications related procedures occurred. One patient died from myocardial infarct and one suffered from ischemic minor stroke in brainstem for a median follow-up of 346.5 days. One of 9 patients (11.1%) was observed in-stent stenosis in the follow-up angiography. Angioplasty and stenting was a potential alternative therapy for symptomatic occlusion of carotid artery. Further study is required to determine the safety of this treatment.

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Section: Discussionmentioning

confidence: 99%

Angioplasty and stenting for the occluded internal carotid artery

Yue

Liu

et al. 2010

J Thromb Thrombolysis

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“…17 Grubb et al 6 used positron-emission tomography scanning to establish the importance of hemodynamic factors in predicting outcomes among these patients. Medical management alone may be inadequate, 18 and revascularization may be beneficial in patients with impaired cerebral perfusion due to chronic ICAO. 19 In our series, all patients were enrolled because of recurrent neurological deficit or objective hemisphere ischemia after documentation of the occlusion, and in theory, they should benefit from revascularization.…”

Section: Discussionmentioning

confidence: 99%

Procedural Safety and Potential Vascular Complication of Endovascular Recanalization for Chronic Cervical Internal Carotid Artery Occlusion

Lin

et al. 2008

Circ: Cardiovascular Interventions

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Background-Patients with chronic cervical internal carotid artery occlusion (ICAO) and cerebral ischemia may benefit from revascularization. The feasibility of endovascular recanalization for chronic ICAO has been reported recently, but its safety is still unproven. We report the follow-up results of 54 chronic ICAO patients who underwent endovascular recanalization, focusing on potential vascular complications and corresponding management. Methods and Results-Endovascular recanalization for chronic ICAO was attempted in 54 consecutive patients (48 men; 69.2Ϯ9.8 years old) with either recurrent neurological deficit or objective ipsilateral hemisphere ischemia. Mean duration from occlusion documentation to the procedure was 237Ϯ327 days (range, 56 to 1424 days). Adverse events while in the hospital and during the 3-month follow-up were recorded. Successful recanalization was achieved in 35 of 54 patients (65%). Three-month cumulative stroke and death rate was 4% (2 of 54), including 1 in-hospital fatal nonipsilateral stroke and 1 in-hospital minor ipsilateral stroke secondary to systemic hypotension. Vascular complications developed in 3 of 54 patients (6%), including 1 late pseudoaneurysm formation 3 months after recanalization, 1 immediate carotid-cavernous fistula after recanalization, and 1 minor extravasation at carotid bifurcation after failed recanalization. However, no clinical sequela was noted with close follow-up and adequate management. Conclusion-Certain immediate or delayed vascular complications may develop during or after the endovascular recanalization for chronic ICAO. Although periprocedural death and stroke rate is limited in our study, further study combining neuroimaging tools and cognitive function evaluation is mandatory to assess its utility and appropriateness in patients with chronic ICAO. (Circ Cardiovasc Intervent. 2008;1:119-125.)

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“…Grubb et al (7) used positron-emission tomography scanning to describe the importance of hemodynamic factors in predicting outcomes among these patients. It implies that medical management alone may not be suitable for certain patients (16), and efforts to select patients with impaired hemodynamics for EC-IC bypass surgery are ongoing (17).…”

Section: Discussionmentioning

confidence: 99%