Surgical treatment for pseudo-occlusion of the internal carotid artery

Desole, Alessandro; Campanile, Francesco; Tosato, Federico; Milite, Domenico

doi:10.1093/icvts/ivv016

Cited by 10 publications

(9 citation statements)

References 17 publications

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“…This exceeds the rate found by Marquering et al 1 of 11%. In contrast, Desole et al 6 reported a carotid pseudo-occlusion rate of 2.3%. This difference may have emerged because they studied patients who are chronically occluded, while we only included cases with acute stroke.…”

Section: Introductionmentioning

confidence: 88%

“…These are thought to occur because occlusion at different segments of the ICA results in arrested blood flow that inhibits contrast propagation and lumen filling in CTA imaging. 6 The aetiologic reasons for pseudo-occlusion defined on CTA can be classified as atherosclerosis and ulcerated plaque at the ICA orifice, cervical ICA dissection, atrial fibrillation (AF) and acute thrombosis of the stent.…”

Section: Introductionmentioning

confidence: 99%

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Aetiologies of internal carotid artery pseudo-occlusions in acute stroke patients: what neurointerventionalists can expect

Akpınar¹,

Gelener²,

Yılmaz³

2017

The British Journal of Radiology

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In cases of acute stroke, differentiation between an occluded and a patent internal carotid artery (ICA) is crucial for diagnosis and management. Although CT angiography (CTA) can be highly accurate in defining high-grade stenosis and ICA occlusions, misleading ICA occlusion patterns are not rare in patients with acute stroke. We investigated the underlying causes of ICA pseudo-occlusions with CTA with respect to digital subtraction angiography. 11 out of 72 patients had pseudo-occlusion on CTA. Of these, there were three cases of tandem occlusions accompanying highgrade ICA stenosis, five cases of Distal ICA bifurcation occlusion as a result of atrial fibrillation, two cases of cervical ICA dissection and one acute thrombosis of the stent. Consideration of the aforementioned aetiologies by interventionists is warranted, as it may change the planning of endovascular intervention and treatment of acute stroke.

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Section: Introductionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Aetiologies of internal carotid artery pseudo-occlusions in acute stroke patients: what neurointerventionalists can expect

Akpınar¹,

Gelener²,

Yılmaz³

2017

The British Journal of Radiology

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“…7,8 The term "pseudo-occlusion" has also been used for chronic high-grade stenosis of the ICA with minimal distal flow. 9,10 This phenomenon is markedly different from pseudo-occlusion as an artifact of single-phase CTA, in which there is, in fact, no practically relevant carotid obstruction at all. 6 To our knowledge, 6 previous studies have described a total of 48 patients with pseudoocclusions of the extracranial ICA in acute ischemic stroke.…”

mentioning

confidence: 91%

Accuracy of CT Angiography for Differentiating Pseudo-Occlusion from True Occlusion or High-Grade Stenosis of the Extracranial ICA in Acute Ischemic Stroke: A Retrospective MR CLEAN Substudy

Kappelhof¹,

Marquering

Berkhemer

et al. 2018

AJNR Am J Neuroradiol

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“… 10 For patients with TIAs or strokes, several studies demonstrated that surgical intervention by means of ligation of the ICA, endarterectomy with patch closure, eversion endarterectomy, carotid bypass and carotid angioplasty and stent (CAS) to be safe and effective. 11 – 14 …”

Section: Discussionmentioning

confidence: 99%

Outcome following open and endovascular intervention for carotid stump syndrome

Dulai

Elsherif

Tawfick

et al. 2018

SAGE Open Medical Case Reports

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Carotid stump syndrome is defined as the persistence of retinal or cerebral ischaemic events with complete occlusion of the ipsilateral internal carotid artery. The aim of this retrospective cases series was to assess the outcomes for patients with carotid stump syndrome managed with surgical intervention. A series of 11 cases of carotid stump syndrome in nine patients presented to our tertiary vascular centre from October 2004 to February 2016. Indications for intervention were amaurosis fugax, transient ischaemic attacks and stroke. In total, 11 procedures were performed on nine patients including carotid angioplasty and stenting or carotid endarterectomy with patching. The mean follow-up period was 56.6 months. One patient suffered a myocardial infarction 30 days, post-operatively, and one patient was lost to follow-up. In the remaining seven patients, there was a complete resolution of symptoms. There were no incidents of death, stroke, cranial nerve injury, wound haematoma or procedural bleeding. Surgical exclusion of carotid stumps combined with dual antiplatelet agents was found to be a safe and effective treatment method for carotid stump syndrome.

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Surgical treatment for pseudo-occlusion of the internal carotid artery

Abstract: Surgical treatment for carotid artery pseudo-occlusion is safe and effective.

Cited by 10 publications

References 17 publications

Aetiologies of internal carotid artery pseudo-occlusions in acute stroke patients: what neurointerventionalists can expect

Aetiologies of internal carotid artery pseudo-occlusions in acute stroke patients: what neurointerventionalists can expect

Accuracy of CT Angiography for Differentiating Pseudo-Occlusion from True Occlusion or High-Grade Stenosis of the Extracranial ICA in Acute Ischemic Stroke: A Retrospective MR CLEAN Substudy

Outcome following open and endovascular intervention for carotid stump syndrome

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