scholarly journals Surgical Revascularization for Internal Carotid Artery Stenosis in the Acute Stage of Cerebral Infarction

2020 ◽  
Vol 70 (4) ◽  
pp. 343-348
Author(s):  
Ryosuke Shintoku ◽  
Tasuku Yajima ◽  
Takeo Kojima ◽  
Toshiyuki Ohtani
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cerebral Infarction ◽  
Carotid Artery Stenosis ◽  
Internal Carotid ◽  
Acute Stage ◽  
Internal Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Surgical Revascularization

scholarly journals Clinical risk factors predictive of thrombotic stroke with large cerebral infarction

2019 ◽  
Vol 11 (2) ◽  
Author(s):  
Worapot Rojsanga ◽  
Kittisak Sawanyawisuth ◽  
Verajit Chotmongkol ◽  
Somsak Tiamkao ◽  
Kannikar Kongbonkiat ◽  
...  
Keyword(s):  
Risk Factors ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cerebral Infarction ◽  
Carotid Artery Stenosis ◽  
Stroke Risk ◽  
Internal Carotid ◽  
Internal Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Stroke Risk Factors

Large cerebral infarctions have high morbidity and mortality. Patients with large cerebral infarctions may have recurrent ischemia as high as 8.1% within 7 days; highest among other types of strokes. Data regarding risk factors for large cerebral infarction in Asian populations are still scant. All adult (age ≥15 years old) patients with the diagnosis of thrombotic ischemic stroke who were treated at Srinagarind Hospital, Khon Kaen University, Thailand from January 2012 to December 2013 were studied. Large cerebral infarctions are defined by clinical criteria of having cerebral cortical impairment, brain stem or cerebellar dysfunction with infarction sizes of more than 1.5 cm. The association of various stroke risk factors and large infarction strokes were calculated using multiple logistic regression analysis. There were 276 thrombotic stroke patients who met the study criteria; classified as large cerebral infarctions in 59 patients (21.38%) and small cerebral infarctions in 217 patients (78.62%). Baseline characteristics and risk factors for stroke were comparable between both groups. The large cerebral infarction group had a significantly larger proportions of right internal carotid artery stenosis, plaques on the left side, left internal carotid artery stenosis, and internal carotid artery stenosis at any side than the small cerebral infarction group. Among various stroke risk factors, only internal carotid artery stenosis at any side was the only significant factor associated with large cerebral infarction with an adjusted odds ratio of 11.14 (95% CI: 3.46, 35.82). In conclusion, significant internal carotid artery stenosis is associated with large cerebral infarction.

scholarly journals Endovascular treatment for acute carotid T and carotid non-T occlusion: A retrospective multicentre study of 81 patients

2019 ◽  
Vol 25 (5) ◽  
pp. 497-501
Author(s):  
Takahiro Ota ◽  
Keigo Shigeta ◽  
Tatsuo Amano ◽  
Junya Kaneko
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cerebral Infarction ◽  
Carotid Artery Stenosis ◽  
Internal Carotid ◽  
Treatment Strategies ◽  
Internal Carotid Artery Stenosis ◽  
Artery Stenosis ◽  
Arterial Dissection ◽  
Bleeding Complications

Background The functional prognosis of patients with carotid T occlusion is poor, but few comprehensive studies have investigated carotid non-T occlusion, in which the terminal internal carotid artery portion is unobstructed. We aimed to elucidate the clinical features of carotid non-T occlusion by comparing patients with acute carotid T occlusion and carotid non-T occlusion. Methods Among 362 patients who underwent thrombectomy between January 2015 and June 2018, 20 and 61 were diagnosed with carotid non-T occlusion and carotid T occlusion, respectively. We compared preoperative clinical findings, treatment strategies, treatment complications and functional outcomes between the two groups. Results Age, sex, preoperative National Institutes of Health stroke scale, cerebral infarction subtypes and medical history did not significantly differ. In contrast, preoperative diffusion-weighted imaging–Alberta Stroke Program early computed tomography scores were 9 (1–11) and 6.5 (0–11) for the carotid non-T occlusion and carotid T occlusion groups, respectively ( P = 0.015). The duration of treatment or the median number of passes (2.5 vs. 2.0), the numbers of patients with thrombolysis in cerebral infarction 2b/3, bleeding complications and modified Rankin scale scores of 0–2 on postoperative day 90 did not significantly differ between the two groups. Manual aspiration before, internal carotid artery arrest while crossing a lesion and injection into the contralateral side were significantly more frequent in patients with carotid non-T occlusion. Intracranial internal carotid artery stenosis was significantly more frequent in patients with carotid non-T occlusion ( n = 4, 20%) than carotid T occlusion ( n = 0), and 10% of patients with carotid non-T occlusion had arterial dissection. Conclusion Patients with carotid non-T occlusion more frequently had a background of intracranial internal carotid artery stenosis or arterial dissection than patients with carotid T occlusion. Specific treatment strategies should be developed to improve the clinical outcomes of patients with carotid non-T occlusion.

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