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The contralateral carotid disease in patients with internal carotid artery occlusion

Arijana Lovrencić-Huzjan1, Maja Strineka, Drazen Aiman

  • 1University Department of Neurology, Reference Center for Neurovascular Disorders, Ministry of Health and Social Welfare of the Republic of Croatia, Sestre milosrdnice University Hospital, Zagreb, Croatia. arijana.lovrencic-huzjan@zg.t-com.hr

Acta Clinica Croatica
|January 9, 2010
PubMed

Insights

Internal carotid artery occlusion (ICAO) affects about 6 in 100,000 people. One-third of patients with ICAO experience progression of contralateral carotid disease, requiring further investigation and management.

Area of Science:

  • Vascular Surgery
  • Neurology
  • Cardiology

Background:

  • Internal carotid artery occlusion (ICAO) presents a significant risk for stroke.
  • Patients with ICAO, particularly those who have undergone carotid endarterectomy (CES), face an increased risk of contralateral carotid stenosis progression.
  • Understanding the natural history and management of contralateral disease in ICAO patients is crucial for stroke prevention.

Purpose of the Study:

  • To investigate the management and natural history of contralateral internal carotid artery disease in patients diagnosed with internal carotid artery occlusion (ICAO).
  • To assess the rate of progression of carotid stenosis in the contralateral artery among patients with unilateral ICAO.
  • To evaluate the outcomes of interventions for contralateral carotid disease in the context of ICAO.

Main Methods:

  • Retrospective analysis of follow-up examinations for 297 patients with ICAO over a one-year period.
  • Patients were categorized based on the presence and severity of contralateral carotid artery disease.
  • Data on disease progression, interventions, and postoperative outcomes were collected and analyzed.

Main Results:

  • Contralateral carotid disease progression was observed in approximately one-third (30%) of patients with ICAO.
  • Among 106 patients with ICAO and mild to moderate contralateral changes, 21 progressed to subtotal stenosis, leading to surgery in 18.
  • In a subgroup of 44 patients with ICAO and initial subtotal contralateral stenosis, 42 underwent surgery, with varied postoperative outcomes including stenosis and occlusion.

Conclusions:

  • Contralateral carotid artery disease progression is a significant concern in patients with internal carotid artery occlusion (ICAO), affecting about a third of cases.
  • The findings highlight the need for vigilant monitoring and timely intervention for contralateral carotid stenosis in ICAO patients.
  • Further research is warranted to optimize the management strategies for this patient population to mitigate stroke risk.

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