Total Occlusion of the Common Carotid Artery: A Modified Classification and its Relation to Clinical Status
| Autor: | Christos V. Ioannou, Dimitrios G. Kardoulas, Konstantia I. Angelidou, Dimitrios G. Parthenis, Pavlos N. Antoniadis, Asterios N. Katsamouris, Alexandros Kafetzakis |
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| Rok vydání: | 2008 |
| Předmět: |
Carotid Artery Diseases
Male medicine.medical_specialty Acoustics and Ultrasonics Carotid Artery Common External carotid artery Biophysics Collateral Circulation Ophthalmic Artery medicine.artery Carotid artery disease Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Common carotid artery Ultrasonography Doppler Color Stroke Aged Aged 80 and over Radiological and Ultrasound Technology business.industry medicine.disease Collateral circulation Stenosis Ischemic Attack Transient Regional Blood Flow Ophthalmic artery Cardiology Female Radiology Internal carotid artery business |
| Zdroj: | Ultrasound in Medicine & Biology. 34:867-873 |
| ISSN: | 0301-5629 |
| DOI: | 10.1016/j.ultrasmedbio.2007.11.015 |
| Popis: | To investigate the hemodynamics and clinical presentation of common carotid artery occlusion (CCAO), we reviewed 6,415 patients with suspected carotid artery disease in whom a color Duplex imaging (CDI) examination was performed. According to distal vessel patency, the following CDI classification of CCAO was adopted: type I (patent both distal vessels); type II (isolated patency of external carotid artery); type III (isolated patency of internal carotid artery); and type IV (both distal vessels occluded). Thirty-five (0.5%) cases met the CDI criteria for CCAO. Twenty-nine of those (83%) had at least one patent distal vessel. Ten patients (29%) presented with stroke, 20 (57%) with transient ischemic attacks (TIAs) and five (14%) were asymptomatic. The incidence of stroke was higher in type IV (50%) vs. type II (30%) and in type II vs. type I (10%) lesions. Similarly, TIAs presented more often in type II (67%) and IV (50%) vs. in type I (40%) lesions (p = 0.002). Retrograde flow in the ophthalmic artery and concomitant severe contralateral carotid artery stenosis were more often related with type II and IV lesions (p = 0.02 and 0.04, respectively). CCAO is usually accompanied by patent distal vessel(s). The proposed CCAO classification correlates well with the patients' clinical status and may help to better clarify the outcome of this rare entity. Among the main arteries of the developed collateral circulation, only the flow direction in the ophthalmic artery may be of clinical value. |
| Databáze: | OpenAIRE |
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