Risks of stroke and current indications for cerebral revascularization in patients with carotid occlusion

Neurosurg Clin N Am. 2001 Jul;12(3):473-87, vii.

Abstract

Preventing further stroke in patients with complete carotid artery occlusion remains a difficult challenge because there is no therapy proven effective for this prevention. These patients comprise approximately 15% of patients with carotid artery territory transient ischemic attacks or infarction. Patients with symptomatic carotid artery occlusion have an overall risk of subsequent stroke of 7% per year and a risk of stroke ipsilateral to the occluded carotid artery of 5.9% per year. The presence of severe hemodynamic failure demonstrated by increased oxygen extraction fraction (OEF) of the brain, in a cerebral hemisphere distal to a symptomatic occluded carotid artery, is an independent predictor of subsequent ischemic stroke with a risk comparable to that seen in medically treated patients with symptomatic severe carotid artery stenosis.

Publication types

  • Review

MeSH terms

  • Brain / blood supply*
  • Brain / surgery*
  • Carotid Stenosis / complications*
  • Cerebral Revascularization / methods*
  • Cerebrovascular Circulation / physiology
  • Hemodynamics / physiology
  • Humans
  • Risk Factors
  • Stroke / etiology*
  • Stroke / prevention & control
  • Stroke / surgery*