• SCVS Home
• President's Message
• Council
• Commitees
• Annual Meeting
• 37th Annual Symposium
• 36th Annual Symposium
• 35th Annual Symposium
• 34th Annual Symposium
• 33rd Annual Symposium
• Membership
• Join SCVS
• Members Only Area
• Find a Vascular Specialist
• Newsletters
• Journal
• History
• Mission Statement
• Bylaws
• Contact Us
• 37th Annual Symposium
• 36th Annual Symposium
• 35th Annual Symposium
• 34th Annual Symposium
• 33rd Annual Symposium
• Join SCVS
• Members Only Area
• Find a Vascular Specialist

Outcome Analysis of Carotid Artery Occlusion

Objectives: To identify factors which might influence the outcome of spontaneous carotid artery occlusion.
Methods: A retrospective analysis of 115 patients with spontaneous carotid occlusion identified over 14 years by Duplex scanning in an ICAVL accredited vascular laboratory was performed.
Results: The mean age of study patients was 65.5 years; the majority were white (77%) males (61%) with risk factors including smoking (80%), hypertension (79%), diabetes (40%), peripheral vascular disease (39%) and myocardial infarction (26%). Primary indications for examination included stroke (57%), transient cerebral ischemia (8%), bruit (10%) and either nonspecific or absence of neurologic symptoms (24%). Ultrasound findings were internal carotid (ICA) occlusion (90%), common carotid (CCA) occlusion (3%), and combined ICA/CCA occlusion (6%). The contralateral ICA was occluded in 6 patients (5%) and congenitally absent in one; 68 (59%) had < 50% contralateral stenosis, while 18 (16%) had severe 80-99% stenosis. Analysis of results demonstrated no correlation between stroke and patient demographics, risk factors, treatment regimen or the degree of contralateral carotid disease. Overall, 36 patients (31%) required contralateral endarterectomy with a perioperative stroke rate of 2.8% and no perioperative mortality. On follow-up (mean 6.8 years), the mortality of the group was 46%. Only one patient died as an immediate consequence of their stroke.
Conclusion: There is a signficant risk of stroke and of contralateral occlusive disease with identified spontaneous carotid artery occlusion. Neither occurence can be reliably predicted by clinical criteria. Surgical endarterectomy can be performed with acceptable risk despite the presence of contralateral occlusion.