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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

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Management of Bilateral Carotid Occlusive Disease

Ashutosh P Jadhav1, Andrew F Ducruet1, Brian T Jankowitz1

  • 1Departments of Neurology and Neurosurgery, UPMC Stroke Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa., USA.

Interventional Neurology
|April 7, 2016
PubMed

Insights

Symptomatic bilateral internal carotid artery disease is rare and serious. Carotid stenting showed promise as a safe and effective treatment for patients with this condition, leading to good recovery.

Area of Science:

  • Neurology
  • Vascular Surgery
  • Interventional Cardiology

Background:

  • Symptomatic bilateral internal carotid occlusive disease presents a significant risk of mortality and recurrent stroke.
  • Current medical management strategies offer limited efficacy, highlighting an unmet need for optimal treatment approaches.
  • The optimal management for this rare condition remains poorly defined.

Purpose of the Study:

  • To evaluate the safety and effectiveness of carotid stenting in patients with symptomatic bilateral internal carotid occlusive disease.

Main Methods:

  • Retrospective review of a prospectively maintained database.
  • Inclusion criteria: patients presenting with acute stroke and bilateral carotid occlusive disease (May-October 2013).
  • Analysis of clinical presentation, imaging findings, treatment, and functional outcomes.

Main Results:

  • Three patients were identified with bilateral internal carotid occlusions and anterior circulation infarcts.
  • Initial management included permissive hypertension and anticoagulation, followed by carotid angioplasty and stenting.
  • All patients achieved a modified Rankin Scale score of 0-1 at 1-year follow-up, indicating minimal to no disability.

Conclusions:

  • Carotid stenting appears to be a safe and effective therapeutic option for patients with symptomatic bilateral carotid occlusions.
  • This intervention may lead to favorable functional outcomes in a patient population with limited treatment alternatives.
Abstract

Keywords:
Acute strokeCarotid occlusionInterventionRevascularization

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