Lovrencić-Huzjan Arijana, Strineka Maja, Aiman Drazen, Strbe Sanja, Sodec-Simicević Darja, Demarin Vida
University Department of Neurology, Reference Center for Neurovascular Disorders, Ministry of Health and Social Welfare of the Republic of Croatia, Sestre milosrdnice University Hospital, Zagreb, Croatia.
Acta Clin Croat. 2009 Sep;48(3):241-6.
The one-year incidence of carotid occlusion is 6/100 000 inhabitants in general population. Stroke incidence and mortality rate in these patients vary. Patients that underwent carotid endarterectomy (CES) are at a higher risk of progression of contralateral carotid stenosis. The aim of the study was to investigate the management and natural history of the contralateral internal carotid artery disease in patients with internal carotid artery occlusion (ICAO). During one year, 297 patients with ICAO were investigated. Follow up examinations were retrospectively analyzed and patients were divided into groups according to contralateral carotid disease. Out of 297 patients, only one investigation was performed in 90 patients with carotid occlusion. Thirty three patients were followed up due to postoperative ICAO. In 14 patients, ICAO developed during ultrasonographic follow up. In this group of patients, 9 had unchanged contralateral findings, whereas in 5 patients disease progression was observed. Out of 44 patients with ICAO and contralateral subtotal stenosis at initial investigation, 42 underwent carotid surgery. Postoperatively, 32 patients had normal findings, 6 developed mild carotid stenosis, 2 developed moderate carotid stenosis, and 2 had postoperative carotid occlusion. Two patients were followed-up without intervention. Nine patients with bilateral ICAO were followed-up for years. Follow up was continued in 106 patients with ICAO and contralateral mild to moderate changes. The finding was unchanged in 68 patients. In 21 (30%) patients the disease progressed to subtotal stenosis and 18 patients underwent carotid surgery. Accordingly, contralateral carotid disease progression was observed in one third of patients with carotid occlusion. Additional studies on the issue are needed.
在普通人群中，颈动脉闭塞的一年发病率为每10万居民中有6例。这些患者的中风发病率和死亡率各不相同。接受颈动脉内膜切除术（CES）的患者对侧颈动脉狭窄进展的风险更高。本研究的目的是调查颈内动脉闭塞（ICAO）患者对侧颈内动脉疾病的管理和自然病程。在一年时间里，对297例ICAO患者进行了调查。对随访检查进行回顾性分析，并根据对侧颈动脉疾病将患者分组。在297例患者中，90例颈动脉闭塞患者仅进行了一次检查。33例患者因术后ICAO接受随访。在14例患者中，ICAO在超声随访期间出现。在这组患者中，9例对侧检查结果未改变，而5例观察到疾病进展。在初次检查时有ICAO且对侧次全狭窄的44例患者中，42例接受了颈动脉手术。术后，32例患者检查结果正常，6例出现轻度颈动脉狭窄，2例出现中度颈动脉狭窄，2例术后出现颈动脉闭塞。2例患者未进行干预接受随访。9例双侧ICAO患者随访多年。106例有ICAO且对侧有轻度至中度改变的患者继续接受随访。68例患者的检查结果未改变。21例（30%）患者疾病进展为次全狭窄，18例患者接受了颈动脉手术。因此，在三分之一的颈动脉闭塞患者中观察到对侧颈动脉疾病进展。对此问题还需要进一步研究。
