Bilateral carotid artery occlusion: clinical presentation and outcome

In a 4-year period, 17 patients were diagnosed as having bilateral carotid artery obstruction on ultrasonic duplex examination. Twelve had been referred because of recent neurological symptoms and the remaining 5 during cardiac or peripheral vascular work-up. Three patients had a completely silent occlusion of their two carotid arteries. Cardiac and/or peripheral vascular symptoms were present in 11 subjects. Mean follow-up was 28 months. No further strokes occurred. The 3-year cumulative stroke-free survival by life-table analysis was 75%. Myocardial infarction was the cause of death in 2 of 4 patients. For some patients with bilateral carotid artery occlusion, the clinical outcome is better than anticipated.