title: The treatment of cerebral ischemia by external carotid artery revascularization.
abstract: Thirteen patients with internal carotid artery occlusion and symptomatic external carotid artery stenosis underwent external carotid artery revascularization by means of endarterectomy (n = 10) or subclavian artery--external carotid artery bypass (n = 3). All patients but one were followed up, for five to 46 months (mean, 20 months). There were no operative deaths or complications and no late strokes. One patient (7.7%) required early extracranial-intracranial (EC-IC) bypass for failure of the external carotid artery endarterectomy to relieve the initial symptoms. All remaining patients were completely (n = 9) or partially (n = 2) relieved of symptoms, and EC-IC bypass was not required. There were no criteria identified by either oculopneumoplethysmography or angiography that could reliably predict the need for subsequent EC-IC bypass. Ninety-two percent of the patients were adequately treated with external carotid artery revascularization alone, suggesting that subsequent EC-IC bypass is seldom required in patients with ipsilateral internal carotid artery occlusion and external carotid artery stenosis.
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000503:physiopathology / Q000601:surgery*; D002340:Carotid Artery Diseases / Q000503:physiopathology / Q000601:surgery*; D002342:Carotid Artery, External / Q000601:surgery*; D002548:Cerebral Revascularization; D002560:Cerebrovascular Circulation; D004691:Endarterectomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged