[Pre-occlusive stenosis of the internal carotid artery. Haemodynamic study by Doppler effect, phonoangiography-oculoplethysmography and arteriography (author's transl)].

The diagnosis of near total occlusion of the internal carotid artery was made on a group of 122 patients (90 symptomatic - 32 asymptomatic) by Doppler examination on one hand and carotid phonoangiography and oculoplethysmography, used together, on the other hand. The angiographic examination, including the study of the extra cranial arteries and the intra cerebral vessels, was performed. It has shown that a stenosis (greater than or equal to 90% of an internal carotid artery was the only lesion on 65 patients (53.3%) and that in 57 cases (46.7%) there were multiple lesions. 96 patients (76 symptomatic - 20 asymptomatic) were operated on. 4 patients (4.2%) died but the mortality was none in the group of 20 asymptomatic patients. 19 patients refused the operation and we have noted 7 occlusions of the internal carotid artery and 2 patients died (10.2%). On 7 patients with a surgical contra indication we have noted 1 secondary occlusion. We have to consider a near total occlusion of the internal carotid artery as an emergency. Its diagnosis by non invasive techniques must be followed by heparin therapy and angiographic examination. The carotid endarterectomy will respect the external carotid artery patency.