Internal Carotid Artery Occlusion: Association With Atherosclerotic Disease in Other Arterial Beds and Vascular Risk Factors

Abstract

The aim of this article is to investigate the association between internal carotid artery occlusion (ICAO) and the presence of atherosclerotic disease and vascular risk factors. The clinical characteristics and risk factors of 120 patients presenting with ICAO were retrospectively reviewed. All patients (n = 120) had at least 1 of the 4 vascular risk factor (diabetes, smoking, hypercholesterolemia, and hypertension); 2, 3, or all 4 risk factors were present in 14 to 82 of the patients (11.7% to 68.3%), 10 to 39 of the patients (8.3% to 32.5%), and 9 of the patients (7.5%), respectively. A total of 84 patients (70%) with ICAO had disease in at least 1 additional vascular bed (aorta, coronary or lower limb arteries). In addition to ICAO, vascular disease was present in 2 and all 3 of these arterial beds in 42 (35%) and 9 (7.5%) patients, respectively. Furthermore, stenosis or occlusion of the ipsilateral or contralateral vertebral arteries was recorded in 19 of 120 patients (15.8%). Regarding the contralateral carotid artery, 1 patient had bilateral ICAO. One patient had contralateral common carotid artery occlusion, and 1 patient was excluded from the analysis because of surgery to the contralateral carotid artery. Of the remaining 117 patients, 34 (29.0%) had less than 50% contralateral carotid artery stenosis. Thirty-two patients (27.4%) had 50% to 69%, and 51 (43.6%) had 70% to 99% stenosis. Ultrasonographic imaging of the carotid plaque of the contralateral carotid artery revealed that 52 of the 120 arteries (43.3%) were uniformly or predominantly echolucent (types I and II, respectively). Fifty-nine (49.2%) were predominantly or uniformly echogenic (types III and IV), and 9 (7.5%) could not be classified. A similar distribution of echomorphology was observed on the occluded side. ICAO is associated with widespread atherosclerotic disease and a high prevalence of vascular risk factors. Detection of ICAO should prompt the investigation of other arterial beds and treatment of risk factors.

Manual Therapy and Cervical Arterial Dysfunction, Directions for the Future: A Clinical Perspective

“…heart disease, stroke, transient ischemic attack, peripheral vascular disease); smoking, high serum low density lipoprotein (hypercholesterolemia/hyperlipidemia/high cholesterol-high fat diet); hyperhomocysteinemia; infection by escherichia coli, helicobacter pylori, chlamydia pneumoniae, streptococcus, staphylococcus, salmonella, clostridium, mycobacterium, fungi, yersenia, treponema; and mechanical trauma to vessel [46][47][48][49][50][51][52][53][54][55] . The logic for considering this in cervical MT is simple and is based on the following premises: 1) Atherosclerosis is strongly linked with localized ICA [56][57][58][59] and VA [60][61][62][63][64] dysfunction, and ultimately stroke as a result of this localized dysfunction. 2) Cervical movement affects blood fl ow in these vessels (see above).…”

Determinants of pulse pressure and annual rates of change in the Atherosclerosis Risk in Communities study

“…Numerous risk factors contribute to the development of vascular disease as manifested in atherosclerosis and other cardiovascular diseases [2][3][4][5][6][7][8][9][10][11][12]. Hypertension is well established as one of the most important modifiable risk factors for CVD progression [13].…”

Editorial [ Cardiovascular Risk Factor Modification: A sine qua non in the Management of Vascular Surgery Patients ]

“…Smoking is an established independent vascular risk factor [1,3,12,13]. Like several previous studies, a recent crosssectional population-based survey in Thailand (n=3,499) showed that current smoking was a significant predictor of PAD (adjusted odds ratio [OR], 2.80; 95% confidence interval [CI], 1.66-4.72; p<0.001) [18].…”

“…Hypertension [1][2][3], obesity [1,[3][4][5], diabetes mellitus [1,3,[6][7][8], dyslipidemia [1,3,[9][10][11] and smoking [1,3,12,13] are established risk factors for cardiovascular disease. Despite the accumulating evidence that risk factor modification in vascular patients is beneficial, management remains poor [14][15][16][17].…”