title: Common Carotid Artery Occlusion: A Single-Center Experience in 40 Cases.
abstract: The incidence of common carotid artery occlusion (CCAO) is approximately 3% in patients who undergo angiography for symptomatic cerebrovascular disease; however, few studies have reported on management of this condition. The objective of this article was to analyze risk factors, therapeutic options, and clinical benefits of surgical treatment at a hospital in the city of São Paulo, Brazil. Data were collected from medical records of 40 patients with CCAO who were treated from June 2002 to October 2013. Results were analyzed retrospectively. Most of the patients were men (63.0%), who were significantly younger than women. Most of the participants had hypertension (90.0%), and more than half had a history of smoking (52.5%). The mean number of coexisting comorbidities/risk factors was 2.9 ± 1.0. Half of our sample had ipsilateral patent internal and external carotid artery, and 32.5% presented with an occluded internal carotid artery and a patent external artery. Patients with both an internal and an external occluded carotid artery (12.5%) were significantly older. Contralateral arteriosclerosis was observed in 65% of the patients, mainly represented by 50 to 90% stenosis. Most patients were symptomatic (67.5%), and hemiparesis was the most common symptom (55.0%) found. Most (77.5%) of the patients underwent the medical treatment; one out of three endovascular approaches failed. During the mean follow-up of 55 ± 43 months (range, 2-136 months), 17.5% of the patients died within 4 days after surgical repair and after along 123 months of clinical follow-up. Coexisting comorbidities/risk factors were significantly associated with fatal outcomes, such as acute myocardial infarction. This study provides scientific evidences on treatment and outcomes of CCAO.
authors.affiliation: Department of Vascular Surgery, LIM 2, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil.
authors.forename: Sergio
authors.initials: S
authors.lastname: Belczak
authors.affiliation: Department of Vascular Surgery, LIM 2, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil.
authors.forename: Grace Carvajal
authors.initials: GC
authors.lastname: Mulatti
authors.affiliation: Department of Vascular Surgery, Hospital Israelita Albert Einstein, São Paulo, Brazil.
authors.forename: Sergio Ricardo
authors.initials: SR
authors.lastname: Abrão
authors.affiliation: Department of Vascular Surgery, LIM 2, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil.
authors.forename: Erasmo Simão
authors.initials: ES
authors.lastname: da Silva
authors.affiliation: Department of Vascular Surgery, LIM 2, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Aun
authors.affiliation: Department of Vascular Surgery, LIM 2, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil.
authors.forename: Pedro
authors.initials: P
authors.lastname: Puech-Leão
authors.affiliation: Department of Vascular Surgery, LIM 2, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil.
authors.forename: Nelson
authors.initials: N
authors.lastname: de Luccia
keywords: Rile classification; carotid revascularization; chronic stage; common carotid artery occlusion; open surgery