title: Stroke in patients with occlusion of the internal carotid artery: options for treatment.
abstract: Ischemic stroke may occur in patients in whom vascular imaging shows the ipsilateral internal carotid artery (ICA) to be occluded. In younger patients this is often due to carotid artery dissection, while in older people this most likely results from cardiac embolism or thrombosis secondary to high-grade stenosis at the carotid bifurcation. Interventional techniques aim at recanalization of the carotid artery for early restoration of cerebral blood flow and secondary prevention of future strokes. In chronic ICA occlusion the ischemic infarct may be related to hemodynamic compromise. In this situation, extracranial-intracranial bypass surgery was introduced, but its role remains still unclear. Ischemic stroke may also occur in patients with a chronic occlusion of the contralateral ICA. This situation demands the usual stroke treatment, but surgical and neuroradiological interventions face a higher risk than unilateral vascular pathology. Medical treatment supports stroke prevention in carotid artery occlusion.
authors.affiliation: LVR-Klinikum Düsseldorf, University Hospital Düsseldorf, Düsseldorf, Germany.
authors.forename: John Ih
authors.initials: JI
authors.lastname: Lee
authors.forename: Sebastian
authors.initials: S
authors.lastname: Jander
authors.forename: Alexander
authors.initials: A
authors.lastname: Oberhuber
authors.forename: Hubert
authors.initials: H
authors.lastname: Schelzig
authors.forename: Daniel
authors.initials: D
authors.lastname: Hänggi
authors.forename: Bernd
authors.initials: B
authors.lastname: Turowski
authors.forename: Rüdiger J
authors.initials: RJ
authors.lastname: Seitz
mesh_terms: D000818:Animals; D001921:Brain / Q000098:blood supply* / Q000473:pathology; D002545:Brain Ischemia / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D002343:Carotid Artery, Internal / Q000473:pathology*; D016893:Carotid Stenosis / Q000628:therapy*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D006801:Humans; D020521:Stroke / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*
keywords: carotid artery occlusion; carotid surgery; interventional recanalization; ischemic stroke; stroke prevention; vascular imaging