Address for correspondence:
A-Hyun Cho ,Tel: 82237792433, Fax: 8227828654, Email: ahyun@catholic.ac.kr
Received: August 27, 2015; Accepted: September 18, 2015.
ABSTRACT
Background: The natural history of acute symptomatic ICA occlusion remains unclear and short term follow-up studies have been rarely reported. Therefore, we aimed to investigate the natural history of acute ICA occlusion through short-term follow-up and the factors which are associated with recanalization and poor outcome. Methods: We consecutively enrolled acute ischemic stroke patients within 7 days, in whom acute symptomatic internal carotid artery occlusion was observed. We obtained the demographic data, stroke subtypes, National Institute of Health Stroke Scale (NIHSS) score, modified Rankin scale score at 3 months. We conducted carotid duplex ultrasonography, CT angiography or digital subtraction angiography in 2~9 days after the initial angiography to check recanalization pattern of ICA. Recanalization was classified into complete, partial, and no recanalization. Results: A total of 64 patients with acute symptomatic ICA occlusion were enrolled. Follow-up vessel studies could be done in 53 patients. Follow-up with carotid duplex sonography was done in 23 patients, with CT angiography in 9 and with both methods in 21. Complete recanalization was observed in 5 (9.4%), all of whom received thrombolysis. Partial recanalization was observed in 8 (15.1%) patients. 40 (75.5%) patients did not show recanalization. Cardioembolism (p=0.008) and thrombolytic treatment (p=0.025) were associated factors to the complete recanalization. Recanalization was not associated with the favorable clinical outcome (p>0.999). Conclusions: Recanalization of symptomatic internal carotid artery occlusion is identified in 13 (24.5%) patients. Cardioembolism and thrombolytic treatment were associated factors to the complete recanalization.