Bilateral Internal Carotid Artery Occlusion, External Carotid Artery Stenosis, and Vertebral Artery Kinking: May It Be Asymptomatic?

Asymptomatic Bilateral Internal Carotid Artery Occlusion Associated with Stenosis of the Right External Carotid Artery: Case Report

“…3 In the other case, Fatic et al published the case of an asymptomatic bilateral internal carotid artery occlusion, bilateral external carotid artery stenosis and bilateral kinking of the vertebral artery. 7 In our patient, the evaluation of a carotid murmur allowed us to make the diagnosis of BICAO in a patient with ob-vious atherosclerotic terrain given the presence of several cardiovascular risk factors and the notion of newly diagnosed ischemic heart disease. The best management strategy for this disease remains unclear.…”

“…The clinical spectrum of BICAO varies from a completely asymptomatic occlusion to a fatal ischemic stroke. 7 According to the literature review, the majority of BICAO cases progress to fatal ischemic stroke. In reporting our case, we want to emphasize the interest of detecting this pathology in asymptomatic patients with a history of cardiovascular disease in order to treat it and thus prevent progression to fatal ischemic stroke.…”

“…1 In our case, the patient was asymptomatic suggesting the presence of a satisfactory collateral circulation which was supplied by the anastomose of the distal branches of the external carotid artery with distal branches of the internal carotid artery and/or by the vertebrobasilar system into the Willis circle via the posterior communicating arteries. 3,7 The prevalence of asymptomatic BICAO is unknown. We reviewed another 2 asymptomatic BICAO cases.…”

“…Currently, there is little evidence to support management strategies and no official recommendations for asymptomatic bilateral carotid artery occlusion. 7 Patel's team described the natural history of BICAO in a cohort of 45 patients and evaluated the use of antiplatelets or anticoagulants in those. He concluded that survival favored patients on single antiplatelet (Odds Ratio [OR], 0.67; P ¼.008) or with combination of anticoagulation (OR, 0.67; P ¼.018).…”

Koronarine Širdies Liga Sergančiųjų Smegenų Pokyčių Įvertinimas

“…Šiuo metu mažai žinoma apie besimptomius intrakranijinių kraujagyslių pažeidi-mus, kurie stebimi tarp KŠL sergančiųjų pacientų, tačiau teigiama, jog šie ateroskleroziniai pokyčiai yra glaudžiai susiję su arterijų standumu [5]. Jo nustatymui svarbus MRT, kurio vaizdus nagrinėjome šiame darbe ir turėjome galimybę įvertinti vizualius arterijų sienelių pokyčius (4 pav).…”