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Skull Base 2005; 15(1): 7-14
DOI: 10.1055/s-2005-868159
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Indications for Cerebral Revascularization for Patients with Atherosclerotic Carotid Occlusion

Colin P. Derdeyn1 , 2 , 3 , Robert L. Grubb3  Jr. , William J. Powers1 , 2 , 3
  • 1Mallinckrodt Institute of Radiology and Departments of Washington University School of Medicine, St. Louis, Missouri
  • 2Neurology, Washington University School of Medicine, St. Louis, Missouri
  • 3Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri
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Publication History

Publication Date:
14 April 2005 (online)

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ABSTRACT

Patients with complete carotid occlusion and recent ischemic symptoms are at high risk for subsequent stroke, particularly those with evidence of severe hemodynamic impairment due to poor collateral flow. Treatment options for these patients include direct extracranial to intracranial arterial bypass, or interventions aimed at improving collateral sources of flow such as endarterectomy or angioplasty and stenting of the ipsilateral external carotid artery, the contralateral carotid artery, or the vertebral arteries. The evidence supporting the use of these procedures for patients with complete occlusion of the carotid artery will be the focus of this article. The use of physiologic imaging to select subgroups of patients at high risk due to hemodynamic factors will also be discussed.

KEYWORDS

Atherosclerosis - carotid artery - bypass - hemodynamic impairment

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Colin P DerdeynM.D. 

Mallinckrodt Institute of Radiology and Departments of Neurology, and Neurological Surgery, Washington University School of Medicine

510 South Kingshighway Blvd., St. Louis, MO 63110

Email: derdeync@wustl.edu

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