Internal Carotid Artery Occlusion: Management

Curr Neurol Neurosci Rep. 2022 Jul;22(7):383-388. doi: 10.1007/s11910-022-01201-x. Epub 2022 May 13.

Abstract

Purpose of review: Acute internal carotid artery occlusion (ICAO) is associated with high rates of morbidity and mortality, whereas chronic ICAO can present insidiously with recurrent strokes. In this review, we discuss the medical and surgical management approaches among patients with acute, subacute, and chronic ICAO.

Recent findings: We reviewed the recent literature regarding clinical presentation of acute and chronic cases of ICAO, and discuss the current data, accepted guidelines, and prospects. Surgical, endovascular, or a combination (hybrid) revascularization has been shown to be effective in recanalization with improved functional outcomes in patients with ICAO in comparison to systemic thrombolysis or medical therapy alone. Future prospective or randomized clinical trials are warranted to elucidate the procedural superiority for revascularization of patients with ICAO.

Keywords: Internal carotid artery; Recanalization; Stroke; Vessel occlusion.

Publication types

  • Review

MeSH terms

  • Carotid Artery, Internal / diagnostic imaging
  • Carotid Artery, Internal / surgery
  • Carotid Stenosis* / diagnostic imaging
  • Carotid Stenosis* / surgery
  • Humans
  • Retrospective Studies
  • Stroke* / diagnostic imaging
  • Stroke* / etiology
  • Stroke* / surgery
  • Treatment Outcome