Total occlusion of the common carotid artery with patent internal carotid artery. Identification with color flow Doppler imaging.

Dashefsky, Sidney M.; Cooperberg, PL; Harrison, Philip; Reid, J. D. S.; Araki, Dai

doi:10.7863/jum.1991.10.8.417

Cited by 19 publications

(14 citation statements)

References 4 publications

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“…In the case of intracranial collateral flow, there may be retrograde flow within the ICA distal to a CCA occlusion. 9 However, this is not the case in the overwhelming majority of patients. The reason for the predominance of extracranial collateral flow is not clear.…”

Section: Discussionmentioning

confidence: 90%

“…We presume that after endarterectomy, the blood flow to the brain from the left side increased, perhaps creating a pressure gradient through the collateral pathway of the circle of Willis that was sufficient to overcome the resistance of the right side and produce reversed flow in the ICA. 4,9 The high-resistance flow pattern in the right ICA probably resulted from the direction of flow toward the occluded CCA and the high-resistance arterial network of the ECA.…”

Section: Discussionmentioning

confidence: 99%

“…One explanation may be that communicating arteries are diseased or underdeveloped. 9 Color duplex sonography appears to be an effective method for identifying the patency of the carotid bulb beyond the occluded part of the CCA.…”

Section: Discussionmentioning

confidence: 99%

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Color duplex sonography of occlusion of the common carotid artery with reversed flow in the extracranial internal carotid artery

Dermitzakis¹,

Minardos²,

Kampanarou³

et al. 2002

J of Clinical Ultrasound

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In a small percentage of cases with an occluded common carotid artery (CCA), the patency of the arteries beyond the carotid bulb is preserved. Color duplex sonography is useful for assessing blood flow in these vessels. We present a case of retrograde flow in an internal carotid artery (ICA) with an occluded ipsilateral CCA identified using color duplex sonography in a 70-year-old man with diabetes and known atherosclerotic disease. Color duplex sonography revealed that the right CCA was totally occluded near its origin and that flow was re-established at the bulb. Flow in the right ICA was directed cephalad, with a low-frequency, damped waveform; flow in the right external carotid artery (ECA) was bidirectional, with increased reversed diastolic flow. Extensive atherosclerotic lesions were also found in the left side. Endarterectomy of the left carotid bifurcation was performed. Follow-up color duplex sonography 3 months later revealed a small increase of stenosis in the left CCA and mild stenosis in the left ICA. The right CCA remained occluded, but reversed flow with a high-resistance flow pattern was seen in the ipsilateral ICA that supplied the ECA, which had cephalad-directed flow.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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Color duplex sonography of occlusion of the common carotid artery with reversed flow in the extracranial internal carotid artery

Dermitzakis¹,

Minardos²,

Kampanarou³

et al. 2002

J of Clinical Ultrasound

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“…Such cases have been reported as carotid steal or ECA-to-ICA steal [1] and have been hypothesised to occur only when cross-circulation via the anterior part of the circle of Willis is inadequate [4]. The prevalence of ECA-to-ICA steal was reported as 0.3% among 3,463 patients who underwent colour Duplex ultrasonography [5].…”

Section: Discussionmentioning

confidence: 99%

Stent Placement for Severe Stenosis of the Left Common Carotid Artery with Internal-to-External Carotid Steal

et al. 2014

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We report the case of a 64-year-old male with internal carotid artery (ICA)-to-external carotid artery (ECA) steal due to severe stenosis of the common carotid artery (CCA). Left CCA occlusion was initially diagnosed on 3-dimensional time-of-flight magnetic resonance angiography, but digital subtraction angiography revealed severe stenosis of the left CCA and retrograde flow through the left ICA feeding the left ECA. Diverted blood flow from ECA to ICA in cases with occlusion or severe stenosis of the CCA represents a well-known alternative collateral flow pattern called ECA-to-ICA steal. However, collateral flow from ICA to ECA is rarely observed and may be termed ICA-to-ECA steal. We treated CCA stenosis in our patient by carotid artery stenting (CAS) because his CCA stenosis had been gradually progressing since the initial ischaemic attack. Antegrade ICA flow subsequently recovered. To the best of our knowledge, this is the first report of ICA-to-ECA steal normalised by the treatment of CCA stenosis using CAS. i 2014 S. Karger AG, Basel

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“…This failure may be partly attributed to the relative insensitivity of angiography to slow flow and hemodynamic changes distal to an occluded artery. 4,14 Another reason for the inability to show the pattern of collateral flow may be the fact that angiography causes physiologic alterations, which might have prevailed or changed the hemodynamic status in these patients. 19 Unlike angiography, CDUS provides the ability to investigate hemodynamics in completely physiologic circumstances.…”

Section: Discussionmentioning

confidence: 99%

Carotid steal: report of ten cases.

Özbek

Memiş

Killi

et al. 1998

Journal of Ultrasound in Medicine

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The blood flow may be diverted from the external to the internal carotid artery via the carotid bulb in the absence of flow in the common carotid artery. We aimed to investigate the prevalence, hemodynamics, and clinical features of this condition. Reviewing the records of color duplex ultrasonographic examinations, we found carotid steal in 12 carotid arteries of 10 patients. In three patients flow in the ipsilateral external carotid artery was bidirectional. The steal had been demonstrated angiographically in six patients. The cause of the phenomenon was atherosclerosis, Takayasu arteritis, or trauma. Awareness of this pathway of collateral circulation may contribute to diagnostic work‐up and expand management alternatives.

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Total occlusion of the common carotid artery with patent internal carotid artery. Identification with color flow Doppler imaging.

Cited by 19 publications

References 4 publications

Color duplex sonography of occlusion of the common carotid artery with reversed flow in the extracranial internal carotid artery

Color duplex sonography of occlusion of the common carotid artery with reversed flow in the extracranial internal carotid artery

Stent Placement for Severe Stenosis of the Left Common Carotid Artery with Internal-to-External Carotid Steal

Carotid steal: report of ten cases.

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