The angiographic appearance of the proximal end of internal carotid artery occlusion is reported in 41 patients with acute stroke in the areas of the brain supplied by the carotid artery. All patients had angiography within 6 days of stroke onset, the majority within 24--48 hours. Three angiographic configurations of internal carotid occlusion were found, in descending order of frequency: a sha...

In Part 1 of this review, the definition, terminology, and diagnosis of carotid near-occlusion were presented. Carotid near-occlusions (all types) showed a lower risk of stroke than other severe stenoses. However, emerging evidence suggests that the near-occlusion prognosis with full collapse (higher risk) differs from that without full collapse (lower risk). This systematic review presents wha...

BACKGROUND/PURPOSE Identification of carotid near-occlusion is essential before calculation of percent stenosis because stroke risk is lower than other severe stenosis and the treatment benefit is less. Calculations with reduced distal diameters are fallacious. CT angiography (CTA) is convenient and accurately quantifies internal carotid artery (ICA) stenosis. METHODS In a blinded protocol, 2...

Severe carotid stenosis or occlusion may cause insufficient blood flow and lead to distal artery wall collapse and extensive lumen contraction. Whether this 'adaptive narrowing' can restitute after carotid recanalization is unclear. We report a patient with global ischemia due to occlusions of bilateral carotid and right vertebral arteries. The occluded left carotid was recanalized successfully...

BACKGROUND AND PURPOSE The purpose of this study was to investigate the possibility of obtaining prognostic indications in patients with internal carotid occlusion on the basis of intracranial hemodynamic status, presence of previous symptoms of cerebrovascular failure, and baseline characteristics. METHODS Cerebral hemodynamics were studied with transcranial Doppler ultrasonography. Cerebrov...

Three patients with symptomatic carotid cavernous fistulas (CCFs) characterized by complete occlusion of the proximal internal carotid artery were treated by percutaneous puncture and embolization. Two patients had CCFs associated with traumatic dissections of the internal carotid artery and were treated initially with trapping procedures. Both patients had persistent symptoms related to the CC...

The indications for carotid endarterectomy are sometimes imprecise. Total occlusion of the internal carotid artery has often implied irreversibility. Carotid thromboendarterectomy was performed on eight patients who on angiography had a complete occlusion of proximal internal carotid artery but showed antegrade opacification of the infraophthalmic carotid siphon. Direct magnification, delayed r...

BACKGROUND AND PURPOSE Carotid angioplasty and stenting (CAS) may be more often associated with residual or recurrent stenosis than carotid endarterectomy (CEA). We compared the rates of restenosis in patients treated with CAS or CEA in the EVA-3S trial. METHODS Five hundred seven patients (242 treated by CAS and 265 by CEA) had carotid ultrasound follow-up (mean carotid ultrasound follow-up,...

PURPOSE Carotid angioplasty and stenting has been proposed as a treatment option for carotid occlusive disease in patients at high risk, including those 80 years of age or older or with contralateral carotid occlusion. We analyzed 30-day mortality and stroke risk rates of carotid endarterectomy (CEA) in patients aged 80 years or older with concurrent carotid occlusive disease. METHODS From a ...

We describe a unique case of Kimura's disease in which cerebral infarction was caused by occlusion of the right internal carotid artery. A 25-year-old man with Kimura's disease was admitted to our hospital because of left hemiparesis. Computed tomography and magnetic resonance imaging of the head showed infarction in the right frontal and temporal lobes. Cerebral angiography demonstrated right ...