• Vascular Annual Meeting
• General Information
• Call for Abstracts
• Exhibitor Information
• Future Meeting Dates
• Past Meeting Information
• Contact Us

Acute Occlusion Of The Internal Carotid Artery (ICA): Reappraisal Of Emergency Vascular Surgery Based On Modern Stroke Imaging

Barbara T. Weis-Mueller, Mario Siebler, Ruediger Seitz, Wilhelm Sandmann.
University Hospital Duesseldorf, Duesseldorf, Germany.

OBJECTIVES: Evaluation of modern stroke imaging for selection of patients, who can undergo emergency reconstruction for acute ICA occlusion without significant risk of intracranial hemorrhage (IH).

METHODS: From Nov 1997 to July 2006 3500 patients were examined at our stroke unit and nearly 300 patients underwent ICA reconstruction, out of which 34 patients (27 men, 7 women, mean age 61 years) underwent emergency reconstruction for acuta ICA occlusion within 72 (mean 25) hours after the onste of symptoms and within 36 (mean 16) hours after admission to our stroke unit. Diagnostic work-up consisted of extra/intracranial duplex, CT, DSA, MRA, MRI including diffusion and perfusion weighed imaging. Unconscious patients and those with occlusion of the distal siphon and the ipsilateral MCA, infarction larger than 1/3 of the MCA territory were excluded.

RESULTS: Patency was 88 %, IH occurred in 2 (6%) patients. 30-day mortality was 6 %. Rates of clinical improvement (Rankin), stability and deterioration were 59 %, 29 % and 6 % ,respectively.

CONCLUSIONS: Patients with stroke from acute ICA occlusion will benefit from emergency surgery if properly selected based on clinical and angiographical findings and stroke imaging.