BACKGROUND AND PURPOSE: We examined indications for emergent revascularisation of acutely occluded internal carotid artery (ICA) using current diagnostic methods. MATERIAL AND METHODS: From 1997 to 2006 we prospectively followed 34 consecutive patients undergoing emergency revascularisation due to acute extracranial ICA occlusion and acute ischaemic stroke within 72 h after symptom onset (mean 25) and within 36 h after admission (mean 16). Exclusion criteria were occlusion of the intracranial ICA or ipsilateral middle cerebral artery (MCA), ischaemic infarction of more than one third of the MCA perfusion area, or reduced level of consciousness. All patients underwent duplex sonography, cerebral CT, and/or MRI and angiography (MRA and/or DSA). We performed endarterectomy and thrombectomy of the ICA. RESULTS: Confirmed by postoperative duplex sonography at discharge, ICA revascularisation was successful in 30 (88%) of 34 cases. Postoperative intracranial haemorrhage was detected in two patients (6%) and perioperative reinfarction in one (3%). Compared to the preoperative status, 20 patients (59%) showed signs of clinical improvement by at least one point on the Rankin scale, ten patients (29%) remained stable, and two patients (6%) had deteriorated. The 30-day mortality was 6% (two patients). CONCLUSION: After careful diagnostic workup, revascularisation of acute extracranial ICA occlusion is feasible with low morbidity and mortality.
BACKGROUND AND PURPOSE: We examined indications for emergent revascularisation of acutely occluded internal carotid artery (ICA) using current diagnostic methods. MATERIAL AND METHODS: From 1997 to 2006 we prospectively followed 34 consecutive patients undergoing emergency revascularisation due to acute extracranial ICA occlusion and acute ischaemic stroke within 72 h after symptom onset (mean 25) and within 36 h after admission (mean 16). Exclusion criteria were occlusion of the intracranial ICA or ipsilateral middle cerebral artery (MCA), ischaemic infarction of more than one third of the MCA perfusion area, or reduced level of consciousness. All patients underwent duplex sonography, cerebral CT, and/or MRI and angiography (MRA and/or DSA). We performed endarterectomy and thrombectomy of the ICA. RESULTS: Confirmed by postoperative duplex sonography at discharge, ICA revascularisation was successful in 30 (88%) of 34 cases. Postoperative intracranial haemorrhage was detected in two patients (6%) and perioperative reinfarction in one (3%). Compared to the preoperative status, 20 patients (59%) showed signs of clinical improvement by at least one point on the Rankin scale, ten patients (29%) remained stable, and two patients (6%) had deteriorated. The 30-day mortality was 6% (two patients). CONCLUSION: After careful diagnostic workup, revascularisation of acute extracranial ICA occlusion is feasible with low morbidity and mortality.
Authors: H H Eckstein; P Ringleb; A Dörfler; K Klemm; B T Müller; M Zegelman; H Bardenheuer; W Hacke; T Bruckner; W Sandmann; J R Allenberg Journal: J Vasc Surg Date: 2002-11 Impact factor: 4.268
Authors: Osama O Zaidat; Michael J Alexander; Jose I Suarez; Robert W Tarr; Warren R Selman; David S Enterline; Tony P Smith Journal: Neurosurgery Date: 2004-12 Impact factor: 4.654
Authors: S Flacke; E Keller; A Hartmann; P Mürtz; J Textor; H Urbach; P Folkers; F Träber; J Gieseke; W Block; L Scheef; C Leutner; D Pauleit; H H Schild Journal: Rofo Date: 1998-05
Authors: Werner Hacke; Geoffrey Donnan; Cesare Fieschi; Markku Kaste; Rüdiger von Kummer; Joseph P Broderick; Thomas Brott; Michael Frankel; James C Grotta; E Clarke Haley; Thomas Kwiatkowski; Steven R Levine; Chris Lewandowski; Mei Lu; Patrick Lyden; John R Marler; Suresh Patel; Barbara C Tilley; Gregory Albers; Erich Bluhmki; Manfred Wilhelm; Scott Hamilton Journal: Lancet Date: 2004-03-06 Impact factor: 79.321
Authors: E Sbarigia; D Toni; F Speziale; A Falcou; M L Sacchetti; M A Panico; M Fiorelli; C Argentino; E Ducasse; P Fiorani Journal: Int Angiol Date: 2003-12 Impact factor: 2.789