Symptomatic acute occlusion of the internal carotid artery: Reappraisal of urgent vascular reconstruction based on current stroke imaging

Weis-Müller, Barbara Theresia; Huber, Rita; Spivak-Dats, Asya; Turowski, Bernd; Siebler, Mario; Sandmann, W.

doi:10.1016/j.jvs.2007.11.042

Cited by 31 publications

(22 citation statements)

References 35 publications

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“…86,87 Similar outcomes have been reported with emergent CEA. 88 There is currently a significant lack of data comparing expedited CEA to expedited CAS in patients who are recently symptomatic.…”

Section: Acute Stroke and Tandem Lesionsmentioning

confidence: 99%

Carotid artery stenting: Current state of evidence and future directions

et al. 2019

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Both carotid endarterectomy (CEA) and carotid artery stenting (CAS) are common treatments for carotid artery stenosis. Several randomized controlled trials (RCTs) have compared CEA to CAS in the treatment of carotid artery stenosis. These studies have suggested that CAS is more strongly associated with periprocedural stroke; however, CEA is more strongly associated with myocardial infarction. Published longterm outcomes report that CAS and CEA are similar. A reduction in complications associated with CAS has also been demonstrated over time. The symptomatic status of the patient and history of previous CEA or cervical radiotherapy are significant factors when deciding between CEA or CAS. Numerous carotid artery stents are available, varying in material, shape and design but with minimal evidence comparing stent types. The role of cerebral protection devices is unclear. Dual antiplatelet therapy is typically prescribed to prevent in-stent thrombosis, and however, evidence comparing periprocedural and postprocedural antiplatelet therapy is scarce, resulting in inconsistent guidelines. Several RCTs are underway that will aim to clarify some of these uncertainties. In this review, we summarize the development of varying techniques of CAS and studies comparing CAS to CEA as treatment options for carotid artery stenosis. K E Y W O R D Scarotid artery atherosclerosis, carotid artery stenosis, carotid artery stenting, carotid endarterectomy, stroke, stroke prevention | 319 LAMANNA et AL.

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Section: Acute Stroke and Tandem Lesionsmentioning

confidence: 99%

Carotid artery stenting: Current state of evidence and future directions

et al. 2019

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“…1 In the Discussion section, they cited our previous article 2 and stated "Nowadays interventional teams are also dealing with acute ICA occlusion. The largest series was actually presented by a Taiwanese group, who treated 30 patients with acute cervical ICA occlusion by using endovascular techniques."…”

Section: Regarding "Symptomatic Acute Occlusion Of the Internal Carotmentioning

confidence: 99%

Regarding “Symptomatic acute occlusion of the internal carotid artery: Reappraisal of urgent vascular reconstruction based on current stroke imaging”

Lin

Kao

2009

Journal of Vascular Surgery

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tients (N ϭ 684 patients). When compared with all patients (N ϭ 75 studies), high-risk patients had lower odds ratio (EVAR/OSR) of cardiac, pulmonary, and renal problems. Lower rates of type I endoleak or conversion were also observed in high-risk patients. 3 Other results indicated that EVAR outcomes had improved over time as previously reported by Frank et al. 4 We continue collecting data on these high-risk patients to evaluate the midterm outcomes associated with EVAR and OSR, which will confirm if EVAR is cost-effective in high-risk patients based on longer-term data.

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“…Moreover, its benefits in stroke patients remain unclear. Though not common, carotid endarterectomy (CEA) has been reportedly successful in some patients with acutely occluded ICA [11]. In our patient, the location of the carotid occlusion made such surgical revascularization untenable.…”

Section: Discussionmentioning

confidence: 81%

Case of “Slow” Stroke from Carotid Artery Occlusion Treated by Delayed but Cautious Endovascular Intervention

Illoh

Supsupin

Shaltoni

et al. 2011

Stroke Research and Treatment

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In a challenging case of carotid occlusion with slowly evolving stroke, we used brain imaging to facilitate endovascular revascularization resulting in the relief of the patient's symptoms. Patients with carotid occlusion and continued neurological worsening or fluctuations present enormous treatment challenges. These patients may present “slow” strokes with subacute infarcts that present significant challenges and risks during attempts at revascularization of the occluded artery. We present such a case in which we used multimodal imaging techniques, including MR-perfusion, to facilitate endovascular revascularization. Our approach of delayed but cautious intra-arterial thrombolytic therapy, guided by brain imaging, and followed by stent placement across the residual stenosis, enabled revascularization of the occluded artery without overt in-hospital complications.

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Symptomatic acute occlusion of the internal carotid artery: Reappraisal of urgent vascular reconstruction based on current stroke imaging

Cited by 31 publications

References 35 publications

Carotid artery stenting: Current state of evidence and future directions

Carotid artery stenting: Current state of evidence and future directions

Regarding “Symptomatic acute occlusion of the internal carotid artery: Reappraisal of urgent vascular reconstruction based on current stroke imaging”

Case of “Slow” Stroke from Carotid Artery Occlusion Treated by Delayed but Cautious Endovascular Intervention

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