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. 2013 Sep 16;2013:198595.
doi: 10.1155/2013/198595. eCollection 2013.

Common Carotid Artery Occlusion: A Case Series

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Free PMC article

Common Carotid Artery Occlusion: A Case Series

Zoltán Bajkó et al. ISRN Neurol. .
Free PMC article

Abstract

Subjects and Methods. We analysed 5000 cerebrovascular ultrasound records. A total of 0.4% of the patients had common carotid artery occlusion (CCAO). Results. The mean age was 59.8 ± 14.2 years, and the male/female ratio was 2.33. The most frequent risk factors were hypertension, ischaemic heart disease, dyslipidemia, diabetes mellitus, and smoking. Right-sided and left-sided CCAO occurred in 65% and 30% of the cases, respectively, and bilateral occlusion was detected in one case (5%). Patent bifurcation was observed in 10 cases of CCAO in which the anterograde flow in the ICA was maintained from the external carotid artery with reversed flow. In two of the cases, the occluded CCA was hypoplastic. The aetiology of CCAO in the majority of cases was the atherosclerosis (15 cases). The male/female ratio was higher in the patients with occluded distal vessels, and the short-term outcome was poorer. Only two cases from this series underwent revascularisation surgery. Spontaneous recanalisation was observed in one case. Conclusions. The most frequent cause of CCAO was atherosclerosis. The outcome is improved in the cases with patent distal vessels, and spontaneous recanalisation is possible. Treatment methods have not been standardised. Surgical revascularisation is possible in cases of patent distal vessels, but the indications are debatable.

Figures

Figure 1
Figure 1
Ultrasound examination showing CCA occlusion with patent distal vessels. (a) Colour mode examination: no flow in the right common carotid artery, and the vessel lumen is filled with thrombotic material. (b) Colour mode examination of carotid bifurcation: reversed flow in the ECA, anterograde flow in the ICA. (c) Duplex mode examination: anterograde flow in the ICA. (d) Duplex mode examination: retrograde flow in the ECA.
Figure 2
Figure 2
Ultrasound examination showing common carotid artery occlusion with patent distal vessels. Anterograde flow in both the ICA and ECA. (a) Colour mode examination: no flow in the left common carotid artery (LCCA), and the vessel lumen is filled with thrombotic material. (b) Duplex mode examination: anterograde flow in the left internal carotid artery with a steal effect, deceleration, and inversed flow in mesosystole. (c) Duplex mode examination: anterograde flow in the left external carotid artery. (d) Duplex mode examination: retrograde flow in the left superior thyroid artery. (e) Colour mode examination: retrograde flow in the left superior thyroid artery and anterograde flow in LECA.
Figure 3
Figure 3
Ultrasound examination showing multiple steno-occlusive lesions in the cervical vessels. (a) Colour mode examination: RCCA occlusion, no flow in the right common carotid artery, and the vessel lumen is filled with thrombotic material. (b), (c) Duplex mode examination: anterograde flow in the right ICA and retrograde flow in the right ECA. (d) Duplex mode examination, subclavian steal phenomenon, and retrograde flow in the right vertebral artery. (e), (f) Colour mode and duplex mode examination and severe left internal carotid artery stenosis.
Figure 4
Figure 4
Ultrasound examination showing hypoplastic and occluded right CCA. (a) Colour mode examination: RCCA occlusion, no flow in the right common carotid artery, the vessel lumen is filled with thrombotic material, and the vessel diameter is 3.8 mm. (b), (c) Duplex mode examination: anterograde flow in the right ICA and retrograde flow in the right ECA.

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