title: Internal carotid artery occlusion: its natural history including recanalization and subsequent neurological events.
abstract: OBJECTIVE
  To determine the incidence of recanalization of the occluded internal carotid artery (ICA) and establish its natural history.
  
  
  METHODS
  Patients with duplex-confirmed ICA occlusions were identified, and a subgroup offered repeat scanning. The antemortem condition and cause of death of patients who died were recorded.
  
  
  RESULTS
  Of 153 patients identified, 77 underwent follow-up at a median of 35 months (interquartile range [IQR]: 14-61).In all, 8 (10.3%) demonstrated recanalization at a median of 53 months (IQR: 35-114). Of 8, 7 underwent carotid endarterectomy with histopathological confirmation of recanalization. Of the 153 patients, 45 (29%) had further neurological events, and 38 (25%) were within the territory of the occluded ICA. In all, 76 patients died, and of the 53 with a confirmed cause of death, 12 (23%) were attributed to a cerebrovascular accident corresponding to the territory of the occluded artery.
  
  
  CONCLUSIONS
  Recanalization of ICA occlusion is common and leads to significant neurological events. Duplex ultrasound follow-up appears mandatory.
authors.affiliation: 1Department of Surgery, Royal Glamorgan Hospital, Llantrisant, United Kingdom.
authors.forename: G
authors.initials: G
authors.lastname: Morris-Stiff
authors.forename: M
authors.initials: M
authors.lastname: Teli
authors.forename: P Y
authors.initials: PY
authors.lastname: Khan
authors.forename: S O
authors.initials: SO
authors.lastname: Ogunbiyi
authors.forename: C S
authors.initials: CS
authors.lastname: Champ
authors.forename: R
authors.initials: R
authors.lastname: Hibberd
authors.forename: R
authors.initials: R
authors.lastname: Brown
authors.forename: D M
authors.initials: DM
authors.lastname: Bailey
authors.forename: R K
authors.initials: RK
authors.lastname: Winter
authors.forename: M H
authors.initials: MH
authors.lastname: Lewis
mesh_terms: D000368:Aged; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000601:surgery*; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D002423:Cause of Death; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D002908:Chronic Disease; D016894:Endarterectomy, Carotid / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012008:Recurrence; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color
keywords: carotid endarterectomy; cerebrovascular accident; internal carotid artery; occlusion; recanalization