Naslov
OCCLUSION OF INTERNAL CAROTID ARTERY IN ISCHEMIC CEREBROVASCULAR DISEASE

Autori
Đermanović, V. ; Thaller, Nikica ; Čop-Blažić, Nevenka ; Lovrenčić-Huzjan, Arijana ; Demarin, Vida

Izvornik
Acta clinica Croatica (0353-9474) 38 (1999), 1;

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, kongresno priopcenje, znanstveni

Ključne riječi
carotid artery; occlusion; cerebrovascular disease

Sažetak
Fifty-one patients treated at the Department in 1998, with ultrasonographically (US) verified occlusion of one or both internal carotid arteries (ICA) and contralateral ICA findings varying from normal to subtotal stenosis, were included in the study. The following methods were used: computed tomography (CT) brain scanning, color Doppler flow imaging (CDFI) of carotid and vertebral arteries, transcranial Doppler (TCD), and digital subtraction angiography (DSA). Risk factors were assessed from lipidogram, blood glucose, presence of hypertension and cardiovascular diseases, cigarette smoking, and alcohol consumption. There were ten (19.6%) women and 41 (80.4%) men, pointing to a male prevalence of occlusive disease and its development at a younger age. Brain CT findings showed ischemia of the arterial territory to be the most common sequel of ICA occlusion (55%), followed by multiple lesions in 36%, while lacunar lesions were observed in 9% of the patients only. Thorough history analysis revealed 47% of patients to have previously suffered a stroke, whereas 22% of patients had a history of other neurologic deficit, ICA occlusion with the first-ever-in-a-lifetime stroke was recorded in 31%. of patients. Most of the patients with unilateral ICA occlusion also had a less or more severe stenosis of contralateral ICA. Moderate stenosis of the contralateral ICA was recorded in 33.3%, and >50% stenosis in 21.6% of patients. In case of such a finding, US followup is of paramount importance. TCD was used to lemonstrate the presence of collateral mechanisms. Flow velocity decrease on the side of occlusion was recorded in 32%, bilateral flow velocity decrease in 32%, flow velocity increase on the side of occlusion in 16%, and normal finding in 20% of patients. In patients with unilateral ICA occlusion and a history of neurologic deficit combined with the presence of risk factors, US follow-up is highly important for frequent development of contralateral ICA stenosis as well as for the follow-up of vertebral artery pathology (occlusion and tortuosity), which symptomatology occurs as a sign of failure of the compensatory collateral mechanisms.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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