Journal of Neurocritical Care (Dec 2015)

Short-Term Recanalization of Symptomatic Internal Carotid Artery Occlusion

  • Hyun Jo Lee,
  • Seungyoo Kim,
  • Yoon Sang Oh,
  • Woojun Kim,
  • A-Hyun Cho

DOI
https://doi.org/10.18700/jnc.2015.8.2.103
Journal volume & issue
Vol. 8, no. 2
pp. 103 – 108

Abstract

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Background: The natural history of acute symptomatic ICA occlusion remains unclear. Short term follow-up studies have been rarely reported. Therefore, the objective of this study was to determine the natural history of acute ICA occlusion through short-term follow-up. In addition, we determined factors associated with recanalization and poor outcome. Methods: We consecutively enrolled acute ischemic stroke patients within 7 days who had acute symptomatic internal carotid artery occlusion. Demographic data, stroke subtypes, National Institute of Health Stroke Scale (NIHSS) score, and modified Rankin scale score at 3 months were recorded. Carotid duplex ultrasonography, CT angiography, or digital subtraction angiography in 2-9 days after the initial angiography was conducted to check recanalization pattern of ICA. Recanalization was classified into complete, partial, or no recanalization. Results: A total of 64 patients with acute symptomatic ICA occlusion were enrolled in this study. Follow-up vessel studies were completed for 53 patients. Follow-up carotid duplex sonography was performed for 23 patients. CT angiography was performed for 9 patients. Both carotid duplex sonography and CT angiography were performed for 21 patients. Complete recanalization was observed in 5 (9.4%) of the 53 patients. All five patients received thrombolysis. Partial recanalization was observed in 8 (15.1%) patients. The remaining 40 (75.5%) patients did not show recanalization. Cardioembolism (P=0.008) and thrombolytic treatment (P=0.025) were factors associated with complete recanalization. However, recanalization (P>0.999) was not associated with favorable clinical outcome. Conclusion: Recanalization of symptomatic internal carotid artery occlusion was identified in 13 (24.5%) patients. Cardioembolism and thrombolytic treatment were factors significantly associated with complete recanalization.

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