title: Carotid endarterectomy for symptomatic complete occlusion of the internal carotid artery.
abstract: We described 9 consecutive patients who underwent operative carotid artery exploration with attempted carotid endarterectomy (CEA) for symptomatic internal carotid artery (ICA) occlusion. Indications for this surgery based on vascular imaging included segmental occlusion of the proximal ICA and also extensive occlusion of the distal ICA in selected patients in whom color-flow duplex ultrasound showed a poorly echogenic or anechoic thrombus with a flow void, suggestive of an acute thrombus. CEA was performed successfully to restore blood flow in all 9 patients:CEA in 5 and CEA with Fogarty thrombectomy in 4. Postoperative magnetic resonance (MR) angiography confirmed that revascularization had been successful in all 9 patients, and MR imaging displayed improved perfusion in 4 patients. Despite the lack of a generalized efficacy of surgical revascularization for symptomatic ICA occlusion, our study demonstrated that preoperative vascular imaging allows the selection of patients who may benefit from CEA.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea. ypcho@amc.seoul.kr
authors.forename: Yong-Pil
authors.initials: YP
authors.lastname: Cho
authors.forename: Tae-Won
authors.initials: TW
authors.lastname: Kwon
authors.forename: Sun U
authors.initials: SU
authors.lastname: Kwon
authors.forename: Won-Young
authors.initials: WY
authors.lastname: Chae
authors.forename: Geun-Eun
authors.initials: GE
authors.lastname: Kim
mesh_terms: D000368:Aged; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016894:Endarterectomy, Carotid / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow; D012189:Retrospective Studies; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D018616:Ultrasonography, Doppler, Duplex; D014652:Vascular Diseases / Q000473:pathology / Q000601:surgery*