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ULTIMO FASCICOLOINTERNATIONAL ANGIOLOGY

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

 ORIGINAL ARTICLES

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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