Diagnostic and therapeutic alternatives in patients with symptomatic "carotid occlusion" referred for extracranial-intracranial bypass surgery.
An increasing number of patients with symptomatic carotid artery occlusion are being referred for extracranial to intracranial bypass grafts. After careful clinical and angiographic assessment, a number of these patients have been treated with a direct approach to the carotid arteries in the neck or with anticoagulation rather than with a bypass graft. These patients may be categorized diagnostically under the following heading: 1) complete occlusion of the internal carotid artery (ICA) with intracranial patency; 2) spontaneous dissection of the ICA: 3) atheromatous pseudo-occlusion; 4) carotid artery occlusion with stenosis of the contralateral ICA; 5) occlusion of the ICA and stenosis of the external carotid artery; and 6) thrombus in the intracranial segment of an occluded ICA. Each of these categories is discussed briefly, and illustrative cases are presented.
D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D001157:Arterial Occlusive Diseases / Q000188:drug therapy / Q000601:surgery*; D002340:Carotid Artery Diseases / Q000188:drug therapy / Q000601:surgery*; D002342:Carotid Artery, External / Q000601:surgery; D002343:Carotid Artery, Internal / Q000601:surgery; D002533:Cerebral Angiography; D002548:Cerebral Revascularization; D003251:Constriction, Pathologic / Q000601:surgery; D004691:Endarterectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D013927:Thrombosis / Q000188:drug therapy
D000925:Anticoagulants