Carotid stump syndrome: a colour-coded Doppler flow study.
Colour-coded Doppler flow imaging (angiodynography) was performed on 29 patients with 30 internal carotid artery occlusions. Large internal carotid stumps were revealed as intravascular cul-de-sacs demonstrating vortices of blue flow reversal. Large carotid stumps or significant external carotid stenoses were present in nine patients (9 arteries). Such patients were significantly more likely to develop symptoms of cerebral ischaemia during follow up which averaged 18 months (P = 0.016; Fisher exact). These results support the concept of embolisation from the carotid bifurcation (residual stump or external stenosis) as a cause of episodic cerebral ischaemia following internal carotid occlusion. Angiodynography may prove to be a useful tool for selecting appropriate patients for treatment.
Quill
D S
DS
Department of Peripheral Vascular Surgery, School of Medicine, Southern Illinois University, Springfield 62794-9230.
Colgan
M P
MP
Sumner
D S
DS
D000328:Adult; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000175:diagnosis*; D002340:Carotid Artery Diseases / Q000150:complications / Q000175:diagnosis*; D002343:Carotid Artery, Internal; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow; D014463:Ultrasonography / Q000379:methods*