Risks of stroke and current indications for cerebral revascularization in patients with carotid occlusion.
Preventing further stroke in patients with complete carotid artery occlusion remains a difficult challenge because there is no therapy proven effective for this prevention. These patients comprise approximately 15% of patients with carotid artery territory transient ischemic attacks or infarction. Patients with symptomatic carotid artery occlusion have an overall risk of subsequent stroke of 7% per year and a risk of stroke ipsilateral to the occluded carotid artery of 5.9% per year. The presence of severe hemodynamic failure demonstrated by increased oxygen extraction fraction (OEF) of the brain, in a cerebral hemisphere distal to a symptomatic occluded carotid artery, is an independent predictor of subsequent ischemic stroke with a risk comparable to that seen in medically treated patients with symptomatic severe carotid artery stenosis.
Grubb
R L
RL
Department of Neurology and Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Powers
W J
WJ
D001921:Brain / Q000098:blood supply* / Q000601:surgery*; D016893:Carotid Stenosis / Q000150:complications*; D002548:Cerebral Revascularization / Q000379:methods*; D002560:Cerebrovascular Circulation / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D012307:Risk Factors; D020521:Stroke / Q000209:etiology* / Q000517:prevention & control / Q000601:surgery*