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Current Atherosclerosis Reports

Erschienen in:

01.10.2017 | Cardiovascular Disease and Stroke (S. Prabhakaran, Section Editor)

Internal Carotid Artery Occlusion: Pathophysiology, Diagnosis, and Management

verfasst von: Konark Malhotra, Nitin Goyal, Georgios Tsivgoulis

Erschienen in: Current Atherosclerosis Reports | Ausgabe 10/2017

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Abstract

Purpose of Review

Acute internal carotid artery occlusion (ICAO) is associated with large infarcts and poor clinical outcomes and contributes to morbidity and mortality worldwide. In this review, we discuss various etiologies and pathophysiology of clinical presentations of ICAO, different radiographic patterns, and management of patients with ICAO.

Recent Findings

Recanalization rates remain suboptimal with systemic thrombolysis amongst patients with acute ICAO. Recent success of endovascular therapy for vessel occlusion in anterior circulation has expanded the horizons; however, few patients with cervical dissections and ICAO were included in these landmark trials.

Summary

Acute ICAO responds poorly to intravenous thrombolysis and portends worse clinical outcomes. Extracranial and intracranial ICAOs have varied clinical course and imaging patterns, with discrete cervical ICAO usually associated with better clinical outcomes while tandem occlusions predispose poor outcomes. Diagnostic catheter-based angiogram is often required since appearances of ICAO using non-invasive neuroimaging modalities are often deceiving. Repeated vascular imaging in acute to subacute phase to determine recanalization of ICAO is critical for secondary prevention. Recent success of endovascular procedures will continue to expand the horizons to improve the management of ICAO.

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Titel: Internal Carotid Artery Occlusion: Pathophysiology, Diagnosis, and Management
verfasst von: Konark Malhotra
Nitin Goyal
Georgios Tsivgoulis
Publikationsdatum: 01.10.2017
Verlag: Springer US
Erschienen in: Current Atherosclerosis Reports / Ausgabe 10/2017
Print ISSN: 1523-3804
Elektronische ISSN: 1534-6242
DOI: https://doi.org/10.1007/s11883-017-0677-7

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