Urgent endovascular treatment of acute symptomatic occlusion of the cervical internal carotid artery.
OBJECTIVE
The prognosis of patients with acute symptomatic cervical internal carotid artery (ICA) occlusion is generally considered to be poor. Traditionally, such patients are not considered eligible for urgent thrombolytic/endovascular treatment. Since 1998, an aggressive therapeutic approach with endovascular treatment has been adopted at the authors' institution. In this report they assess whether aggressive treatment of ICA occlusion is appropriate.


METHODS
The clinical characteristics and outcome of six consecutive patients treated urgently with an endovascular approach between 1998 and 2001 are reviewed and summarized. Recanalization was accomplished in all patients. At a mean follow-up period of 8 months (range 2-14 months), five of six patients had good or excellent outcomes (modified Rankin Scale [mRS] Score 0-1) and one had a poor outcome (mRS Score 4).


CONCLUSIONS
With recent advancements in thrombolytic and endovascular treatments, an aggressive endovascular approach in patients with acute symptomatic cervical ICA occlusion may be successful. Further clinical data are required to determine the optimal endovascular approach in these patients.
Wang
Huan
H
Department of Neurosurgery, Illinois Neurological Institute, University of Illinois College of Medicine at Peoria, Illinois 61656, USA.
Lanzino
Giuseppe
G
Fraser
Kenneth
K
Tracy
Patrick
P
Wang
David
D
D000208:Acute Disease; D000328:Adult; D000368:Aged; D017130:Angioplasty; D002343:Carotid Artery, Internal / Q000601:surgery*; D016893:Carotid Stenosis / Q000628:therapy*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D015912:Thrombolytic Therapy; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator