title: Angiographic Characteristics of Pseudo-occlusion of the Internal Carotid Artery Before and After Stenting.
abstract: Various definitions of pseudo-occlusion and clinical outcomes after various treatments have been reported, but reports discussing the stenotic characteristics of pseudo-occlusion are rare.
  
  
  
  To analyze the angiographic characteristics of pseudo-occlusion of the internal carotid artery (ICA) before and after carotid artery stenting (CAS).
  
  
  
  We retrospectively reviewed the angiographic characteristics of 56 patients with pseudo-occlusion of the ICA treated with CAS. Angiographic changes were evaluated from digital subtraction angiography in terms of lesion characteristics of the stenosis and the diameter changes in the distal ICA before and after CAS.
  
  
  
  Fifty-six patients were successfully treated. Based on angiographic findings of ICA stenosis, 33 and 23 patients were classified into the single-channel and multiple-channel group, respectively. Regarding the diameter changes in the distal ICA after CAS, 31 cases were classified as immediate dilatation and the other 25 as restricted dilatation. Immediate dilatation of the distal ICA beyond the stent and that at a follow-up examination were observed significantly less frequently in the multiple-channel group than in the single-channel group. The use of multiple stents and stent occlusion at a follow-up examination were significantly more prevalent in the multiple-channel group than in the single-channel group.
  
  
  
  Stenotic lesions of pseudo-occlusion of the ICA were classified as single channel and multiple channel. Restricted dilatation of the distal ICA after CAS was more prevalent in the multiple-channel group. Because adverse events tended to be more frequent in the multiple-channel group than in the single-channel group, the indications for CAS should be determined carefully in multiple-channel patients.
  
  
  
  CAS, carotid artery stentingICA, internal carotid artery.
authors.affiliation: *Department of Neurosurgery, Japanese Red Cross Society Wakayama Medical Center, Wakayama City, Japan;‡Department of Neurosurgery, Showa University Fujigaoka Hospital, Yokohama City, Japan;§Department of Neurosurgery, Wakayama Rosai Hospital, Wakayama City, Japan;¶Department of Neurosurgery, Wakayama Medical University, Wakayama City, Japan;‖Department of Neurosurgery, Ishioka Cardiovascular and Neurosurgical Hospital, Ishioka City, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Matsuda
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Terada
authors.forename: Hideo
authors.initials: H
authors.lastname: Okada
authors.forename: Osamu
authors.initials: O
authors.lastname: Masuo
authors.forename: Kousuke
authors.initials: K
authors.lastname: Ohshima
authors.forename: Mitsuharu
authors.initials: M
authors.lastname: Tsuura
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Nakao
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D002343:Carotid Artery, Internal; D016893:Carotid Stenosis / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome