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Rivista di Angiologia

Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 2003 Marzo;22(1):64-71


Spontaneous recanalization of internal carotid artery occlusion evaluated with color flow imaging and contrast arteriography

Camporese G. 1, Verlato F. 1, Salmistraro G. 1, Ragazzi R. 2, Andreozzi G. M. 1

1 Unit Care of Angi­ol­o­gy, Uni­ver­sity Hos­pi­tal, Padua, Italy
2 Insti­tute of Radiol­o­gy, Uni­ver­sity Hos­pi­tal, Padua, Italy

Aim. In ­strokes of embol­ic ori­gin a par­tial rec­a­nal­iza­tion of the intra­cra­ni­al occlud­ed ves­sel ­occurs with a high inci­dence (as high as 80%). In the lit­er­a­ture, we find few cases of revas­cu­lar­iza­tion, detect­ed with color flow imag­ing (CFI) or with arter­i­og­ra­phy (AGF), at carot­id ­siphon or at the ori­gin of an occlud­ed inter­nal carot­id ­artery (ICA). Up to now there have been no reli­able data on the inci­dence and clin­i­cal con­se­quenc­es of SR of an extra­cra­ni­al ICA occlu­sion. In this case-­report we doc­u­ment 8 cases of SR of occlud­ed ICA ­observed in the last 10 years in our Care Unit.
Meth­ods. We ­observed 8 com­plete ICA occlu­sion at the ori­gin, detect­ed with CFI (8 of 8) and with AGF (7 of 8). All symp­to­mat­ic ­patients and 2 of 5 asymp­to­mat­ic ­patients under­went CT scan in the acute phase of ­stroke. All ­patients under­went CFI fol­low-up (every 6-12 ­monhts) to eval­u­ate con­tra­lat­er­al CCA and ICA and the pres­ence of new focal neu­ro­log­i­cal symp­toms. All ­patients ­assumed BMT (anti­plate­let or anti­co­ag­u­lant ther­a­py).
­Results. SR ­occurred in 6 ­patients ­between 24 and 96 ­months, in 1 ­patient with­in 8 ­months and 1 ­patient with­in 6 ­months from the diag­no­sis of ICA occlu­sion. Diag­no­sis of SR was based in all ­patients with CFI and in 4 ­patients con­firmed with AGF. Five ­patients under­went CT scan that exclud­ed haem­or­rhag­ic trans­for­ma­tion of pre­vi­ous ischem­ic areas or new ischem­ic ­events (2 ­patients did CT scan only after SR). All ­patients under­went CFI fol­low-up in a 3-88 ­months peri­od. There were no new focal neu­ro­log­i­cal symp­toms in 7 of 8 ­patients, 1 ­patient pre­sent­ed aspe­cif­ic neu­ro­log­i­cal symp­toms.
Con­clu­sion. Diag­nos­ing SR of occlud­ed extra­cran­i­cal ICA seems to be more fre­quent than expect­ed. SR is an event that has to be ­researched in fol­low-up of these ­patients; ­besides, it seems to have a rel­a­tive­ly ­benign out­come with ­respect to the onset of new neu­ro­log­i­cal symp­toms.

lingua: Inglese


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