title: Carotid Endarterectomy for Pseudo-occlusion of the Cervical Internal Carotid Artery.
abstract: OBJECTIVE
  This study described clinicopathological characteristics of pseudo-occlusion (PO) of the internal carotid artery (ICA) with regards to the pathological mechanism and the benefit of carotid endarterectomy (CEA).
  
  
  METHODS
  We retrospectively reviewed 17 PO patients who underwent CEA. Clinical presentation, angiographic findings, surgical outcomes and plaque components obtained from CEA were investigated.
  
  
  RESULTS
  PO plaques had more fibrous and two different pathological features, including total occlusion with recanalization and severe stenosis. Plaques of the total occlusion with recanalization (8 patients) were composed of thrombotic total occlusion and lumen recanalization by large neovascular channels, whereas those with severe stenosis (9 patients) were fibrous or fibroatheromatous plaque with severe stenosis of the original lumen. Of all the patients who underwent a carotid angiogram 2 weeks after surgery, 16 were successfully treated, but one showed complete occlusion of the ICA. At the follow-up period, two patients showed restenosis of the ICA. Three patients with complete occlusion or restenosis had histologically fibrous sclerotic plaques.
  
  
  CONCLUSIONS
  Patients with PO had more fibrous plaques and two different histological features, including total occlusion with recanalization or severe stenosis. The plaque histology may be related to the pathogenesis and the surgical outcome.
authors.affiliation: Department of Neurosurgery, Japanese Red Cross Fukuoka Hospital, 3-1-1 Ookusu, Minami-ku, Fukuoka city, Fukuoka, 815-8555, Japan, yokohirata@fukuoka-med.jrc.or.jp.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Hirata
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Sakata
authors.forename: Hirohito
authors.initials: H
authors.lastname: Tsuchimochi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Tsugu
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Onishi
authors.forename: Tooru
authors.initials: T
authors.lastname: Inoue