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Natural history of chronic bilateral internal carotid artery occlusion
M Lazarides1, E Kalodiki, M Williams
1St. Mary's Hospital Medical School, London, UK.
Insights
Chronic bilateral internal carotid artery (ICA) occlusion affects 15 patients, with stroke history in 10. Cardiac issues, not stroke, were the main cause of death, and some patients remained asymptomatic.
Area of Science:
- Vascular Neurology
- Cardiology
- Diagnostic Imaging
Background:
- Chronic bilateral internal carotid artery (ICA) occlusion is a significant vascular condition.
- Understanding its clinical presentation and outcomes is crucial for patient management.
Purpose of the Study:
- To investigate the prevalence and clinical outcomes of chronic bilateral ICA occlusion.
- To identify the primary causes of mortality and morbidity in this patient cohort.
Main Methods:
- Retrospective analysis of 3200 patients over six years.
- Duplex scanning used for diagnosis of chronic bilateral ICA occlusion.
- Follow-up assessment of neurological events and mortality.
Main Results:
- 15 patients (0.47%) diagnosed with chronic bilateral ICA occlusion.
- 10 patients had a prior stroke history.
- Annual stroke rate of 5.5% observed during a mean follow-up of 28.9 months.
- Cardiac ischemia was the leading cause of death (6 patients).
- 5 patients remained asymptomatic, while 3 experienced TIAs.
Conclusions:
- Chronic bilateral ICA occlusion does not invariably lead to neurological deficits.
- Cardiac ischemia poses a greater mortality risk than stroke in patients with this condition.
- Proactive management of cardiac comorbidities is essential for this patient group.
Abstract:
Chronic bilateral ICA occlusion was found in 15 of 3200 patients studied with duplex scanning during a six years period. Ten of these patients had a history of stroke. Mean follow-up was 28.9 months. Six patients died during follow-up, coexisting cardiac ischaemia being the major cause of death. Two patients suffered a stroke (one fatal) resulting in an annual stroke rate of 5.5%, three patients continued to have TIAs and 5 remained asymptomatic. Chronic bilateral ICA occlusion is not always associated with neurological deficit. Coronary ischaemia, more than stroke is the leading cause of death in these patients.