title: Common carotid artery occlusion treatment: revealing a gap in the current guidelines.
abstract: OBJECTIVE
  To review the literature on the management of common carotid artery occlusion (CCAO).
  
  
  METHODS
  A review of English-language medical literature from 1965 to 2012 was conducted using the PubMed and EMBASE databases to find all studies involving management of CCAO. The search identified 21 articles encompassing 146 patients/arteries (73.2% men; mean age 65 ± 6.9 years).
  
  
  RESULTS
  The majority of the patients (93.8%) were symptomatic. Most of the patients (61.5%) had ipsilateral internal carotid artery (ICA) and external carotid artery (ECA) patent, while an occluded ICA and a patent ECA were found in 26.6% of the patients. Eighty per cent of the patients treated underwent a surgical bypass procedure, with the subclavian artery as the most common inflow vessel (64.1%). During the first 30 days of the procedure two strokes (1.5%) were reported. During a follow-up period spanning an average of 25.6 ± 11.2 months nine patients (6.6%) experienced a clinical cerebrovascular event. Seven restenoses (5.1%) and two reocclusions (1.5%) also occurred-eight after open surgical and one after endovascular repair.
  
  
  CONCLUSIONS
  The necessity to intervene to a CCAO remains controversial. This review shows that open surgical management of symptomatic CCA occlusive disease is a safe, durable, and effective therapeutic strategy with low perioperative cerebrovascular morbidity.
authors.affiliation: 1st Department of Surgery - Division of Vascular Surgery, Laiko General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Klonaris
authors.forename: G N
authors.initials: GN
authors.lastname: Kouvelos
authors.forename: M
authors.initials: M
authors.lastname: Kafeza
authors.forename: A
authors.initials: A
authors.lastname: Koutsoumpelis
authors.forename: A
authors.initials: A
authors.lastname: Katsargyris
authors.forename: C
authors.initials: C
authors.lastname: Tsigris
mesh_terms: D001157:Arterial Occlusive Diseases / Q000601:surgery*; D017536:Carotid Artery, Common / Q000601:surgery*; D016893:Carotid Stenosis / Q000601:surgery*; D016894:Endarterectomy, Carotid; D057510:Endovascular Procedures; D006801:Humans; D017410:Practice Guidelines as Topic
keywords: Carotid revascularization; Common carotid artery occlusion; Rile's classification