Internal Carotid Artery Occlusion: Pathophysiology, Diagnosis, and Management

Research output: Contribution to journalReview article

5 Citations (Scopus)

Abstract

Purpose of Review: Acute internal carotid artery occlusion (ICAO) is associated with large infarcts and poor clinical outcomes and contributes to morbidity and mortality worldwide. In this review, we discuss various etiologies and pathophysiology of clinical presentations of ICAO, different radiographic patterns, and management of patients with ICAO. Recent Findings: Recanalization rates remain suboptimal with systemic thrombolysis amongst patients with acute ICAO. Recent success of endovascular therapy for vessel occlusion in anterior circulation has expanded the horizons; however, few patients with cervical dissections and ICAO were included in these landmark trials. Summary: Acute ICAO responds poorly to intravenous thrombolysis and portends worse clinical outcomes. Extracranial and intracranial ICAOs have varied clinical course and imaging patterns, with discrete cervical ICAO usually associated with better clinical outcomes while tandem occlusions predispose poor outcomes. Diagnostic catheter-based angiogram is often required since appearances of ICAO using non-invasive neuroimaging modalities are often deceiving. Repeated vascular imaging in acute to subacute phase to determine recanalization of ICAO is critical for secondary prevention. Recent success of endovascular procedures will continue to expand the horizons to improve the management of ICAO.

Original languageEnglish (US)
Article number41
JournalCurrent Atherosclerosis Reports
Volume19
Issue number10
DOIs
StatePublished - Oct 1 2017

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Internal Carotid Artery
Internal Carotid Artery Dissection
Endovascular Procedures
Secondary Prevention
Neuroimaging
Blood Vessels
Angiography
Catheters
Morbidity
Mortality

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Internal Carotid Artery Occlusion : Pathophysiology, Diagnosis, and Management. / Malhotra, Konark; Goyal, Nitin; Tsivgoulis, Georgios.

In: Current Atherosclerosis Reports, Vol. 19, No. 10, 41, 01.10.2017.

Research output: Contribution to journalReview article

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