Spontaneous Recanalization of Chronic Internal Carotid Artery Occlusions: Report of 3 Cases

Buslovich, Steven; Hines, George L.

doi:10.1177/1538574410380792

Cited by 21 publications

(23 citation statements)

References 11 publications

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“…Unlike recanalization of occluded artery in acute stroke, the spontaneous recanalization of a long-standing occlusion of extracranial artery has been only anecdotally reported [7-9]. The mechanism by which recanalization of chronically occluded carotid arteries occurs is still little known.…”

Section: Discussionmentioning

confidence: 99%

Late Spontaneous Recanalization of Chronic Middle Cerebral Artery Occlusion

et al. 2012

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Early spontaneous recanalization of the middle cerebral artery in acute ischemic phase artery is not uncommon, whereas the late spontaneous recanalization of chronic occluded artery is a very rare phenomenon and exact incidence and the timing of this event have not been quantified. We present a case in which late spontaneous recanalization of long-lasting middle cerebral artery occlusion occurred in the absence of surgical, endovascular and thrombolytic treatments.

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Section: Discussionmentioning

confidence: 99%

Late Spontaneous Recanalization of Chronic Middle Cerebral Artery Occlusion

et al. 2012

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“…Yi et al [11] found that atrial fibrillation is associated with reduced spontaneous recanalization of the occluded large or middle cerebral arteries, whereas stage 3 hypertension may be a contributor to recanalization. Buslovich and Hines [5] reported 3 cases of spontaneous recanalization of chronic internal carotid artery occlusions, 2 of which were treated with endarterectomy and postoperative histopathological examination revealed atherosclerosis. In the present study, all 3 patients suffered with hypertension and smoking histories, which are high-risk factors of atherosclerosis, and compensation of collateral circulation has been established; given the presence of severe focal areas of stenosis of the middle cerebral artery, as well as the absence of proximal embolus origin or cardiac abnormalities, a diagnosis of atherosclerosis was made.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous recanalization of atherosclerotic middle cerebral artery occlusion

et al. 2017

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Rationale:Intracranial vascular atherosclerotic occlusion is one of the most common causes of ischemic stroke world wide. The involvement of large intracranial vessels, in particular, the middle cerebral artery, is usually associated with unfavorable outcomes in patients. Spontaneous recanalization of atherosclerotic occlusion is relatively rare.Patient concerns:The first patient was a 43-year-old male with slurred speech and left-sided weakness for a duration of 24 hours. The second was a 59-year-old male with left-sided weakness over a period of 13 hours. The last was a 49-year-old female patient presented with a 1-month history of right-sided headache.Diagnoses:Atherosclerotic middle cerebral artery occlusion.Interventions:In all cases, oral aspirin (100 mg; once daily), Plavix (75 mg; once daily), and Lipitor (40 mg; once daily) were used . Oral Plavix was stopped 3 months.Outcomes:Spontaneous recanalization occured in the three cases of atherosclerotic middle cerebral artery occlusion.Lessons:Spontaneous recanalization may occur in both early and late stages of atherosclerotic middle cerebral artery occlusion. Clinicians should be aware of this particular condition, as it may represent a relatively favorable prognosis.

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“…To date, only a few scattered reports have documented follow-up data about acute symptomatic ICA occlusion. 5,9,10 Our study has several strengths. First, our subjects are prospectively included 64 consecutive patients with 3-month clinical outcome.…”

Section: Patientsmentioning

confidence: 99%

“…The ischemic stroke was diagnosed with diffusion-weighted MRI and clinical examination. 9,10 They found that most probable etiology of the occlusion was atherosclerotic plaque and partial recanalization was produced by spontaneous lysis. Sometimes recanalization of the occluded internal carotid is heralded by a disabling neurologic deficit and a thromboembolic occlusion of other arteries.…”

Section: Patientsmentioning

confidence: 99%

Short-Term Recanalization of Symptomatic Internal Carotid Artery Occlusion

Lee

Kim

et al. 2015

J Neurocrit Care

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Background: The natural history of acute symptomatic ICA occlusion remains unclear. Short term follow-up studies have been rarely reported. Therefore, the objective of this study was to determine the natural history of acute ICA occlusion through short-term follow-up. In addition, we determined factors associated with recanalization and poor outcome. Methods: We consecutively enrolled acute ischemic stroke patients within 7 days who had acute symptomatic internal carotid artery occlusion. Demographic data, stroke subtypes, National Institute of Health Stroke Scale (NIHSS) score, and modified Rankin scale score at 3 months were recorded. Carotid duplex ultrasonography, CT angiography, or digital subtraction angiography in 2-9 days after the initial angiography was conducted to check recanalization pattern of ICA. Recanalization was classified into complete, partial, or no recanalization. Results: A total of 64 patients with acute symptomatic ICA occlusion were enrolled in this study. Follow-up vessel studies were completed for 53 patients. Follow-up carotid duplex sonography was performed for 23 patients. CT angiography was performed for 9 patients. Both carotid duplex sonography and CT angiography were performed for 21 patients. Complete recanalization was observed in 5 (9.4%) of the 53 patients. All five patients received thrombolysis. Partial recanalization was observed in 8 (15.1%) patients. The remaining 40 (75.5%) patients did not show recanalization. Cardioembolism (P=0.008) and thrombolytic treatment (P=0.025) were factors associated with complete recanalization. However, recanalization (P>0.999) was not associated with favorable clinical outcome. Conclusion: Recanalization of symptomatic internal carotid artery occlusion was identified in 13 (24.5%) patients. Cardioembolism and thrombolytic treatment were factors significantly associated with complete recanalization.

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Spontaneous Recanalization of Chronic Internal Carotid Artery Occlusions: Report of 3 Cases

Cited by 21 publications

References 11 publications

Late Spontaneous Recanalization of Chronic Middle Cerebral Artery Occlusion

Late Spontaneous Recanalization of Chronic Middle Cerebral Artery Occlusion

Spontaneous recanalization of atherosclerotic middle cerebral artery occlusion

Short-Term Recanalization of Symptomatic Internal Carotid Artery Occlusion

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