title: Internal carotid artery stenting in patients with symptomatic atheromatous pseudo-occlusion.
abstract: Angioplasty and stenting of the atheromatous internal carotid artery (ICA), besides in patients with a high surgical risk, may be indicated in specific cases such as contralateral occlusion, acute stroke clinical signs, or atherosclerotic pseudo-occlusion (APO). APO of the ICA is an underrecognized condition due to diagnostic difficulties both with noninvasive methods and even with angiography. Once recognized, there is usually the opportunity for successful revascularization with carotid endarterectomy. However, as the natural history of the APO is poorly characterized, the management of patients remains controversial. While some authors advocate a surgical approach, others consider that APO patients are not at high risk of stroke, making any interventional approach unnecessary. The perioperative risk of stroke in patients with APO is not appreciably greater than in patients with lesser degrees of stenosis and clear recommendation of surgery, although at 2 years that risk seems to be considerably much higher than in the latter patients. Looking for safer interventional procedures is worthwhile. Results of angioplasty and stenting in patients with ICA-APO have not been published yet. We report the results and complications associated with this procedure to address the issue of appropriate management of patients with ICA-APO.
authors.affiliation: Department of Neurology, Hospital Universitario Virgen del Rocío, Sevilla, Spain. golperal@cica.es
authors.forename: Alberto
authors.initials: A
authors.lastname: Gil-Peralta
authors.forename: Alejandro
authors.initials: A
authors.lastname: González
authors.forename: José R
authors.initials: JR
authors.lastname: González-Marcos
authors.forename: Antonio
authors.initials: A
authors.lastname: Mayol
authors.forename: Fernando
authors.initials: F
authors.lastname: Boza
authors.forename: José
authors.initials: J
authors.lastname: Ruano
authors.forename: Aurelio
authors.initials: A
authors.lastname: Cayuela
mesh_terms: D002340:Carotid Artery Diseases / Q000175:diagnosis / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000601:surgery*; D016893:Carotid Stenosis / Q000175:diagnosis / Q000601:surgery*; D002533:Cerebral Angiography; D016894:Endarterectomy, Carotid; D006801:Humans; D011183:Postoperative Complications; D011446:Prospective Studies; D015607:Stents; D016896:Treatment Outcome