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The carotid stump syndrome.

L Cassidy1, P A Grace, D J Bouchier-Hayes

  • 1Department of Surgery, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin.

European Journal of Vascular Surgery
|July 1, 1992
PubMed
Summary

Persistent TIAs after carotid artery occlusion may stem from the artery stump. Surgical stump exclusion effectively prevented further TIAs in most patients, offering a better outcome than antiplatelet therapy alone.

Area of Science:

  • Neurology
  • Vascular Surgery

Background:

  • Transient ischaemic attacks (TIAs) are common following internal carotid artery occlusion.
  • Micro-embolisation from the internal carotid artery stump is a suspected cause of TIAs.

Purpose of the Study:

  • To investigate the link between internal carotid artery stump and persistent TIAs.
  • To evaluate the efficacy of surgical stump exclusion versus antiplatelet therapy for managing these TIAs.

Main Methods:

  • Case series of six patients with persistent TIAs and occluded ipsilateral internal carotid artery with a stump.
  • Comparison of outcomes between four patients undergoing surgical stump exclusion and two patients treated with antiplatelet therapy.

Main Results:

  • Four patients who underwent surgery and stump exclusion remained asymptomatic at 2 years.

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  • Of two patients treated with antiplatelet therapy, one remained asymptomatic, and one died from a cerebro-vascular accident.

    • Conclusions:

    • Surgical exclusion of the internal carotid artery stump appears to be an effective treatment for preventing recurrent TIAs.
    • Antiplatelet therapy alone may be less effective in preventing cerebro-vascular events in this patient population.