Surgical Treatment of Chronic Internal Carotid Artery Occlusion By Saline Endarterectomy

Blaisdell, F. William; Hall, Albert D.; Thomas, Adam

doi:10.1097/00000658-196601000-00016

Cited by 22 publications

(6 citation statements)

References 14 publications

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“…It is feasible to treat CTO of the ICA with CEA therapy, as an established method in the treatment of ICA occlusion ( 87 ). CEA may be performed in patients with retrograde filling to the skull base ( 88 ).…”

Section: Treatmentsmentioning

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: Treatmentsmentioning

confidence: 99%

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

Guo

et al. 2017

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“…The problem is that when a compromised vascular bed is reopened, an ischaemic infarct may be converted into a haemorrhagic infarct. This has been seen to occur in spontaneous cerebrovascular occlusion (Blaisdell et al 1969, Bruetman et aI. 1963, Rob 1969, Wylie et al 1964) and has also happened in a case of posttraumatic thrombosis (Towne et al 1972).…”

Section: Treatment Of Traumatic Carotid Thrombosismentioning

confidence: 93%

“…It is fairly easy technically to open occluded vessels after they have been thrombosed for up to 48 hours (DeBakey et al 1962, Murphey andMaccubbin 1965) or with special techniques, after longer periods (Blaisdell et al 1969, Blaisdelt et al 1966, Cohen et al 1968. A Fogarty catheter technique may be used to extract thrombi from the distal internal carotid artery (Garamella et al 1966).…”

Section: Treatment Of Traumatic Carotid Thrombosismentioning

confidence: 99%

Non-penetrating trauma to the carotid artery with secondary thrombosis and embolism: Treatment by Thrombolysin

1977

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A case of partially occluding post-traumatic thrombosis of the internal carotid artery and secondary embolism of the middle cerebral artery is reported. The patient was treated with Thrombolysin with coincident resolution of clinical symptoms and signs and clearing of the lesions on arteriography. This may have been fortuitous. The subject of traumatic carotid artery thrombosis is reviewed in detail, and its pathophysiology is discussed, especially in relation to facts known about occlusive vascular disease secondary to atherosclerosis and related embolic phenomena. Suggestions are made concerning the treatment of this condition, especially with regard to developing rational criteria for opening vascular beds through evaluation of collateral cerebral blood flow. The uses of microvascular surgical techniques and thrombolytic therapy are considered.

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“…Am weitesten verbreitet ist die Vier-Stadien-Einteilung, in der zwischen der asymptomatischen extrakraniellen Karotisstenose (Stadium I), den transitorischen ischämischen Attacken (Stadium 11), dem akuten Hirninfarkt (Stadium III) und dem abgeschlossenen Hirninfarkt (Stadium IV) unterschieden wird (37,38,107,470,509). Abweichend hiervon wird gelegentlich das Stadium lila als Infarkt mit Regressionstendenz, das Stadium 1I1b als Infarkt ohne Regressionstendenz und das Stadium IV als Infarkt mit Bewußtseinsstörungen definiert (45,321,495), auch wurde das Stadium III als progressiver Schlaganfall, das Stadium IV als akuter und abgeschlossener Schlaganfall bezeichnet (68,110). Denck (1975) unterteilte das Stadium 11 in a: transitorische ischämische Attacken und b: zerebrale Mangeldurchblutung ohne Herdzeichen (103).…”

Section: Stadieneinteilungenunclassified

“…Auch lassen sich akute Verschlüsse der A. carotis revaskularisieren (409,509). Ältere Verschlüsse der A. carotis interna werden, nach unbefriedigenden Ergebnissen früherer Eingriffe (45,46,104,316,483), überwiegend als nicht operabel angesehen (409), unter bestimmten Bedingungen wird teilweise jedoch auch eine Indikation vertreten (302,366,460, 496, 502).…”

Section: Thrombozytenaggregationshemmerunclassified

Diagnostik und Behandlungsmöglichkeiten extrakranieller Verschlußprozesse der Arteria carotis*

Grobe¹

1981

Fortschr Neurol Psychiatr

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Surgical Treatment of Chronic Internal Carotid Artery Occlusion By Saline Endarterectomy

Cited by 22 publications

References 14 publications

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

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

Non-penetrating trauma to the carotid artery with secondary thrombosis and embolism: Treatment by Thrombolysin

Diagnostik und Behandlungsmöglichkeiten extrakranieller Verschlußprozesse der Arteria carotis*

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