Spontaneous recanalization of an occluded internal carotid artery.
Recanalization after extracranial internal carotid artery (ICA) occlusion is a rare phenomenon and the natural history of the disease is largely unknown. There have been few cases reported in the published data, including early recanalization after a cerebrovascular accident (CVA). We report a case of a 74-year-old man who presented with a CVA and a history of multiple CVAs in the past, the last episode being a year ago. Multiple imaging modalities, including duplex scans, computerized tomographic angiograms, and fluoroscopy-guided angiogram of bilateral carotid arteries, showed occlusion of the left ICA in the past. The duplex scan performed 8 months later demonstrated late spontaneous recanalization of the occluded left ICA. The patient underwent successful carotid endarterectomy. The pathophysiology, natural history, and possible surveillance strategy are discussed in this case report.
Shah
Parth S
PS
Division of Vascular Surgery, Maimonides Medical Center, 4802 10th Ave, Brooklyn, NY 11219, USA. pshah2@maimonidesmed.org
Hingorani
Anil
A
Ascher
Enrico
E
Shiferson
Alexander
A
Patel
Nirav
N
Gopal
Kapil
K
D000368:Aged; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000601:surgery; D016893:Carotid Stenosis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D002533:Cerebral Angiography; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000209:etiology; D018450:Disease Progression; D016894:Endarterectomy, Carotid; D006801:Humans; D008297:Male; D012075:Remission, Spontaneous; D012720:Severity of Illness Index; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color