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Bilateral Common Carotid Artery Occlusion as an Adequate Preconditioning Stimulus to Induce Early Ischemic Tolerance to Focal Cerebral Ischemia
07:46

Bilateral Common Carotid Artery Occlusion as an Adequate Preconditioning Stimulus to Induce Early Ischemic Tolerance to Focal Cerebral Ischemia

Published on: May 9, 2013

Bilateral carotid artery occlusion with transient or moderately disabling ischaemic stroke: clinical features and

Suzanne Persoon1, Catharina J M Klijn, Ale Algra

  • 1Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, G03.228, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands. s.persoon@umcutrecht.nl

Journal of Neurology
|June 3, 2009
PubMed

Insights

Patients with bilateral internal carotid artery occlusion have a low risk of recurrent stroke. Medical management and risk factor control appear justified for these individuals.

Area of Science:

  • Neurology
  • Vascular Medicine
  • Clinical Epidemiology

Background:

  • Prognosis data for bilateral internal carotid artery occlusion (ICAO) patients with transient ischemic attack (TIA) or moderate ischemic stroke is limited.
  • Bilateral internal carotid artery occlusion presents unique challenges for stroke risk assessment.

Purpose of the Study:

  • To prospectively evaluate the long-term risk of recurrent ischemic stroke in patients with bilateral ICA occlusion.
  • To determine the incidence of major vascular events (stroke, myocardial infarction, vascular death) in this patient cohort.
  • To identify potential risk factors for adverse vascular outcomes.

Main Methods:

  • Prospective study of 57 consecutive patients with bilateral ICA occlusion presenting with ischemic symptoms.
  • Long-term follow-up to assess recurrent ischemic stroke and composite vascular events.
  • Statistical analysis to determine annual event rates and identify risk factors.

Main Results:

  • The annual stroke rate was 1.2% (95% CI 0.3-3.1), with no identifiable risk factors for recurrence.
  • The annual rate of major vascular events (stroke, myocardial infarction, vascular death) was 5.3% (95% CI 3.1-8.3).
  • Age and a history of ischemic heart disease were significant risk factors for major vascular events.

Conclusions:

  • Patients with TIA or moderate ischemic stroke due to bilateral ICA occlusion have a relatively low risk of recurrent ischemic stroke.
  • Medical therapy and risk factor management may be a justified approach for these patients.
  • Further comparative studies on treatment strategies are warranted.

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