AI Article Synopsis
- Nonoperative treatment for recent internal carotid artery (ICA) occlusion can lead to higher rates of recurrent strokes, prompting analysis of carotid endarterectomy (CEA) as a potential solution.
- From 1990 to 2002, 87 patients with symptoms indicating ICA occlusion were evaluated, leading to technically successful CEA in 30 patients and external CEA in 57 patients with varying symptoms.
- The study concluded that CEA is a feasible and safe option for symptomatic ICA occlusion, suggesting these patients should be considered for the procedure to prevent recurrent strokes.
Article Abstract
Purpose: Nonoperative treatment of recent internal carotid artery (ICA) occlusion is associated with increased recurrent stroke rates. We analyzed our results of carotid endarterectomy (CEA) for treatment of symptomatic recent ICA occlusion to evaluate its feasibility, safety, and outcomes.
Methods: From 1990 to 2002, all patients with transient ischemic attack (TIA), amaurosis fugax, and minor stroke underwent duplex ultrasound (US) scanning and arteriography to confirm the diagnosis of ICA occlusion. Within 2 weeks of symptom onset, patients underwent operative exploration with attempted CEA. ICA occlusion was detected at preoperative angiography and confirmed at surgery. Patients with extensive ICA plaque not amenable to endarterectomy underwent external CEA with ICA ligation.
Results: Over 12 years, 87 patients with symptomatic ICA occlusion underwent 90 operations for ICA exploration. In 30 patients (18 men, 12 women) with TIA (45%), amaurosis fugax (19%), or minor stroke (36%), CEA to treat ICA occlusion was technically successful. There was 1 postoperative stroke, 2 asymptomatic internal carotid occlusions, and no restenoses (mean follow-up, 26 months; range, 1-93 months). In 57 patients (37 men, 20 women) with TIA (41%), amaurosis fugax (27%), or stroke (32%) in whom CEA was unsuccessful, external CEA was performed. In this group there were no postoperative strokes, 2 asymptomatic external carotid artery occlusions, and 1 restenosis (>70%) (mean follow-up, 22 months; range, 1-73 months). There were no late strokes in either group.
Conclusion: Operative exploration and endarterectomy to treat symptomatic ICA occlusion is feasible and safe. Patients with symptomatic ICA occlusion should be considered candidates for CEA.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1067/mva.2003.203 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Internal carotid artery dissection leading to occlusion in a patient with nonelongated styloid process: illustrative case.
J Neurosurg Case Lessons
January 2025
Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan.
Background: Eagle syndrome is characterized by an elongated styloid process causing mechanical stress on the internal carotid artery (ICA). The authors present the case of a patient who had cervical ICA dissection with a nonelongated styloid process.
Observations: A 43-year-old man presented with left hemiparesis and hemispatial neglect.
Diagnosis and treatment of pediatric arterial stenosis associated with neurofibromatosis type 1.
BMC Pediatr
January 2025
Department of Orthopedics, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56, Nanlishi Road, Beijing, 100045, China.
Background: Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disorder affecting multiple systems. However, arterial stenosis is a rare manifestation in patients with NF1. Since the symptoms of arterial stenosis caused by NF1 are often atypical and have a high under-diagnosis rate, this can lead to serious complications such as hypertension, ischemic stroke, or even death.
View Article and Find Full Text PDFThe Circle of Willis (CW) is a critical cerebrovascular structure that supports collateral blood flow to maintain brain perfusion and compensate for eventual occlusions. Increased tortuosity of highrisk vessels within the CW has been implicated as a marker in the progression of cerebrovascular diseases especially in structures like the internal carotid artery (ICA). This is partly due to age-related plaque deposition or arterial stiffening.
View Article and Find Full Text PDFCerebrovascular stenosis related to tyrosine kinase inhibitor for chronic myeloid leukemia: two illustrative cases.
BMC Neurol
January 2025
Department of Neurosurgery, Gifu University Graduate School of Medicine, 1-1, Yanagido, Gifu, 501-1194, Japan.
Background: Tyrosine kinase inhibitors (TKIs) improve prognosis in chronic myeloid leukemia (CML). Nilotinib and ponatinib, second- and third-generation TKIs, respectively, have been reported to cause adverse vascular occlusive events such as myocardial infarction and peripheral arterial disease. However, little is known about the risk of cerebral infarction associated with severe cerebrovascular stenosis, which is a late complication of TKIs.
View Article and Find Full Text PDFSpontaneous Coronary Dissection Review: A Complex Picture.
Rev Cardiovasc Med
December 2024
Cardiologia, Ospedale Maggiore, 26900 Lodi, Italy.
Spontaneous coronary artery dissection (SCAD) represents a quite rare event but with potentially serious prognostic implications. Meanwhile, SCAD typically presents as an acute coronary syndrome (ACS). Despite the majority of SCAD presentation being characterized by typical ACS signs and symptoms, young age at presentation with an atypical atherosclerotic risk factor profile is responsible for late medical contact and misdiagnosis.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!