Cull D L, Hansen J C, Taylor S M, Langan E M, Snyder B A, Coffey C B
Greenville Hospital System, Department of Surgical Education, Greenville, SC 29605, USA.
Ann Vasc Surg. 1999 Jan;13(1):73-6. doi: 10.1007/s100169900223.
Rarely, internal carotid artery (ICA) patency is maintained above a common carotid artery occlusion (CCAO) through collateral flow of the ipsilateral external carotid artery or an aberrant ICA branch. Several small series report excellent results of ICA revascularization in relieving cerebral ischemic symptoms in these patients. The natural history of CCAO with patent ICA in the asymptomatic patient, however, is unknown. The Greenville Memorial Hospital Vascular Teaching Service registry and all carotid duplex scans done in the Greenville Hospital System vascular laboratory from January 1994 through December 1997 were reviewed. Data collection included chart review, phone interviews, and the review of angiograms and duplex scans. This study suggests that carotid duplex is more sensitive for detecting ICA flow after CCAO than routine contrast angiography. It also suggests that while rare in presentation, asymptomatic patients with CCAO and a patent ICA appear to have a benign neurologic course and can probably be observed without a high risk of stroke.
很少见的是，颈内动脉（ICA）通过同侧颈外动脉的侧支血流或异常的ICA分支，在颈总动脉闭塞（CCAO）上方保持通畅。几个小系列报道了ICA血运重建在缓解这些患者脑缺血症状方面的出色结果。然而，无症状患者中ICA通畅的CCAO的自然病程尚不清楚。回顾了格林维尔纪念医院血管教学服务登记处以及1994年1月至1997年12月在格林维尔医院系统血管实验室进行的所有颈动脉双功超声扫描。数据收集包括病历审查、电话访谈以及血管造影和双功超声扫描的审查。这项研究表明，颈动脉双功超声在检测CCAO后ICA血流方面比常规对比血管造影更敏感。它还表明，虽然表现罕见，但CCAO且ICA通畅的无症状患者似乎有良性的神经病程，可能可以进行观察而无高卒中风险。
