Analysis of Reserve Capacity and Subsequent Stenting in a Case of Subacute Occlusion of the Internal Carotid Artery

Kallenberg, Kai; Rühlmann, Johanna; Baudewig, Jürgen; Larsen, Jörg; Gröschel, Sonja; Dechent, Peter; Kastrup, Andreas; Knauth, Michael

doi:10.1007/s00062-012-0172-z

Cited by 2 publications

(1 citation statement)

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“…The factor that most prominently affects the success rate of recanalization is the duration of occlusion. For acute and subacute occlusion of the ICA, both interventional surgery and hybrid surgery are relatively straightforward, mainly as the thrombosis in the ICA has not developed in structure and is relatively soft ( 91 , 107 ). Our experience corroborates this finding.…”

Section: Factors Affecting Recanalizationmentioning

confidence: 99%

Current understanding of chronic total occlusion of the internal carotid artery (Review)

Guo

et al. 2017

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At present, there is limited understanding of chronic total occlusion (CTO) of the internal carotid artery (ICA). Therefore, the present report collected related cases from PubMed and reviewed the literature. Cerebral vessels may form collateral circulation immediately or gradually following CTO of the ICA. The natural history of CTO of the ICA includes a variety of outcomes, all of which are biased toward a non-benign progressive process and are characterized by insufficient cerebral perfusion, embolus detachment and cognitive dysfunction. The majority of cases of CTO of the ICA require treatment. In early studies, the results of external-ICA bypass were unsatisfactory, while recanalization is now considered the only viable option. The current treatment indications mainly depend on the degree of injury to the cerebrovascular reserve and the extent to which the oxygen extraction fraction is increased. The length, height and duration of ICA occlusion are also relevant, though more frequently, the condition depends on multiple factors. Endovascular interventional recanalization, carotid endarterectomy (CEA) and hybrid surgery may be conducted in a select group of patients. As novel materials are developed, the success rate of simple recanalization may gradually increase; however, hybrid surgery may be more representative of the current trend, as advanced CEA can remove carotid atherosclerosis plaques, thus reducing the technological demands of the subsequent interventional recanalization. There are many complications that may result from recanalization following CTO of the ICA, including hyperperfusion and technical errors; therefore, the operation must be conducted carefully. If the recanalization is successful, it typically results in a stable improvement of patient condition in the long term. However, despite these conclusions, more studies are required in the future to further improve current understanding of CTO of the ICA.

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Section: Factors Affecting Recanalizationmentioning

confidence: 99%