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Outcome in patients with symptomatic occlusion of the internal carotid artery.
Eur J Vasc Endovasc Surg. 2000 Jun; 19(6):579-86.EJ

Abstract

OBJECTIVES

to assess whether the risk of recurrent ischaemic stroke in patients with symptomatic internal carotid artery (ICA) occlusion has changed over the past decades, to determine risk factors for the occurrence of ischaemic stroke and to assess the risk of endarterectomy (CEA) of a severe contralateral ICA stenosis.

DESIGN

retrospective cohort study.

PATIENTS AND METHODS

patients with symptomatic ICA occlusion were identified from duplex registry files between 1991 and 1995. Information was obtained on vascular risk factors, performance of CEA for a contralateral ICA stenosis and on recurrence of ischaemic stroke. The rate of complications occurring within 30 days after CEA of the contralateral ICA in patients with symptomatic ICA occlusion was compared with the risk of CEA in patients with asymptomatic ICA occlusion and severe contralateral ICA stenosis (symptomatic or asymptomatic).

RESULTS

ninety-seven patients were identified. Mean follow-up time was 26 months. The annual risk of (non-)fatal stroke was 5.3% for all strokes (95% CI 2. 9%-9.6%) and 3.8% for ipsilateral stroke (95% CI 1.9%-7.7%). Hyperlipidaemia and severe stenosis of the contralateral ICA were independent risk factors. Twenty-two of 32 patients with a severe stenosis of the contralateral ICA underwent CEA, of which one patient died and three suffered a minor ischaemic stroke. The perioperative risk of CEA in the control group of 20 patients with asymptomatic contralateral ICA occlusion was 0% (0 of 20).

CONCLUSIONS

outcome in patients with symptomatic ICA occlusion has not substantially improved over the years. CEA for severe stenosis of the contralateral ICA carried a relatively high risk in our series, but deserves to be studied in a controlled design.

Authors+Show Affiliations

Department of Neurology, University Medical Center Utrecht, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10873724

Citation

Klijn, C J., et al. "Outcome in Patients With Symptomatic Occlusion of the Internal Carotid Artery." European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery, vol. 19, no. 6, 2000, pp. 579-86.
Klijn CJ, van Buren PA, Kappelle LJ, et al. Outcome in patients with symptomatic occlusion of the internal carotid artery. Eur J Vasc Endovasc Surg. 2000;19(6):579-86.
Klijn, C. J., van Buren, P. A., Kappelle, L. J., Tulleken, C. A., Eikelboom, B. C., Algra, A., & van Gijn, J. (2000). Outcome in patients with symptomatic occlusion of the internal carotid artery. European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery, 19(6), 579-86.
Klijn CJ, et al. Outcome in Patients With Symptomatic Occlusion of the Internal Carotid Artery. Eur J Vasc Endovasc Surg. 2000;19(6):579-86. PubMed PMID: 10873724.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcome in patients with symptomatic occlusion of the internal carotid artery. AU - Klijn,C J, AU - van Buren,P A, AU - Kappelle,L J, AU - Tulleken,C A, AU - Eikelboom,B C, AU - Algra,A, AU - van Gijn,J, PY - 2000/6/30/pubmed PY - 2000/8/19/medline PY - 2000/6/30/entrez SP - 579 EP - 86 JF - European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery JO - Eur J Vasc Endovasc Surg VL - 19 IS - 6 N2 - OBJECTIVES: to assess whether the risk of recurrent ischaemic stroke in patients with symptomatic internal carotid artery (ICA) occlusion has changed over the past decades, to determine risk factors for the occurrence of ischaemic stroke and to assess the risk of endarterectomy (CEA) of a severe contralateral ICA stenosis. DESIGN: retrospective cohort study. PATIENTS AND METHODS: patients with symptomatic ICA occlusion were identified from duplex registry files between 1991 and 1995. Information was obtained on vascular risk factors, performance of CEA for a contralateral ICA stenosis and on recurrence of ischaemic stroke. The rate of complications occurring within 30 days after CEA of the contralateral ICA in patients with symptomatic ICA occlusion was compared with the risk of CEA in patients with asymptomatic ICA occlusion and severe contralateral ICA stenosis (symptomatic or asymptomatic). RESULTS: ninety-seven patients were identified. Mean follow-up time was 26 months. The annual risk of (non-)fatal stroke was 5.3% for all strokes (95% CI 2. 9%-9.6%) and 3.8% for ipsilateral stroke (95% CI 1.9%-7.7%). Hyperlipidaemia and severe stenosis of the contralateral ICA were independent risk factors. Twenty-two of 32 patients with a severe stenosis of the contralateral ICA underwent CEA, of which one patient died and three suffered a minor ischaemic stroke. The perioperative risk of CEA in the control group of 20 patients with asymptomatic contralateral ICA occlusion was 0% (0 of 20). CONCLUSIONS: outcome in patients with symptomatic ICA occlusion has not substantially improved over the years. CEA for severe stenosis of the contralateral ICA carried a relatively high risk in our series, but deserves to be studied in a controlled design. SN - 1078-5884 UR - https://www.unboundmedicine.com/medline/citation/10873724/Outcome_in_patients_with_symptomatic_occlusion_of_the_internal_carotid_artery_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1078-5884(00)91129-8 DB - PRIME DP - Unbound Medicine ER -