Harneel Saini1, Russell Cerejo1, Richard Williamson2, Konark Malhotra3. 1. Department of Neurology, Cerebrovascular Center, Allegheny Health Network, Pittsburgh, PA, USA. 2. Department of Neurosurgery, Cerebrovascular Center Allegheny Health Network, Pittsburgh, PA, USA. 3. Department of Neurology, Cerebrovascular Center, Allegheny Health Network, Pittsburgh, PA, USA. konark.malhotra@yahoo.com.
Abstract
PURPOSE OF REVIEW: Acute internal carotid artery occlusion (ICAO) is associated with high rates of morbidity and mortality, whereas chronic ICAO can present insidiously with recurrent strokes. In this review, we discuss the medical and surgical management approaches among patients with acute, subacute, and chronic ICAO. RECENT FINDINGS: We reviewed the recent literature regarding clinical presentation of acute and chronic cases of ICAO, and discuss the current data, accepted guidelines, and prospects. Surgical, endovascular, or a combination (hybrid) revascularization has been shown to be effective in recanalization with improved functional outcomes in patients with ICAO in comparison to systemic thrombolysis or medical therapy alone. Future prospective or randomized clinical trials are warranted to elucidate the procedural superiority for revascularization of patients with ICAO.
PURPOSE OF REVIEW: Acute internal carotid artery occlusion (ICAO) is associated with high rates of morbidity and mortality, whereas chronic ICAO can present insidiously with recurrent strokes. In this review, we discuss the medical and surgical management approaches among patients with acute, subacute, and chronic ICAO. RECENT FINDINGS: We reviewed the recent literature regarding clinical presentation of acute and chronic cases of ICAO, and discuss the current data, accepted guidelines, and prospects. Surgical, endovascular, or a combination (hybrid) revascularization has been shown to be effective in recanalization with improved functional outcomes in patients with ICAO in comparison to systemic thrombolysis or medical therapy alone. Future prospective or randomized clinical trials are warranted to elucidate the procedural superiority for revascularization of patients with ICAO.
Authors: Thomas G Brott; Robert D Brown; Fredric B Meyer; David A Miller; Harry J Cloft; Timothy M Sullivan Journal: Mayo Clin Proc Date: 2004-09 Impact factor: 7.616