London, United Kingdom 2013 Poster Session Red Cerebrovasc Dis 2013; 35 (suppl 3)1-854 289 23 Acute stroke: current treatment Withdrawn! 24 Acute stroke: current treatment Late spontaneous recanalization of symptomatic atheromatous internal carotid artery occlu-sion. M.G. Delgado1, P. Vega2, C.H. Lahoz3, E. Murias4, L. Benavente5, D. Larrosa6, J. Pascual7, S. Calleja8 Hospital Universitario Central de Asturias, Oviedo, SPAIN1, Hospital Universitario Central de Asturias, Oviedo, SPAIN2, Hospital Universitario Central de Asturias, Oviedo, SPAIN3, Hospi-tal Universitario Central de Asturias, Oviedo, SPAIN4, Hospital Universitario Central de Asturias, Oviedo, SPAIN5, Hospital Universitario Central de Asturias, Oviedo, SPAIN6, Hospital Universitario Central de Asturias, Oviedo, SPAIN7, Hospital Universitario Central de Asturias, Oviedo, SPAIN8 Introduction: Definitive treatment of chronic symptomatic atheromatous internal carotid artery (ICA) occlusion remains controversial, as far as late spontaneous recanalization has been described. Methods: We consecutive studied patients with ischemic stroke (January 2003 to August 2012). Inclusion criteria: ischemic stroke in the ICA territory, diagnosis of ICA occlusion (angioMRI or angioCT), atheromatous etiology. Exclusion criteria: thrombolytic treatment, previous known ICA occlusion, other etiology than atheromatous. After discharge, patients were followed by carotid Du-plex. If recanalization was suspected, a complementary angiography study (angio-MRI or angio-CT) was performed. Results: An ICA occlusion was diagnosed in 182 patients. 136/162 patients presented symptomat-ic atheromatous ICA occlusion; of them, 7 patients presented a late spontaneous recanalization (>3 months) of the ICA. In two patients, interventional treatment was performed after recanalization, in one of them after another new ipsilateral stroke. Medical treatment was maintained in the rest of the patients (one patient was admitted due to contralateral internal carotid ischemic event). We found twelve cases of symptomatic atheromatous chronic internal carotid occlusion as described in the lit-erature. In two patients, a contralateral ischemic symptomatology was described after recanalization. In six cases, interventional treatment was performed and in six cases, antithrombotic treatment was maintained. Conclusion: Following of patients with symptomatic atheromatous ICA occlusion should be done with carotid Duplex and if late recanalization is suspected, it might be confirmed by another neu-roimaging study such as CT angiography. Revascularization techniques in these patients should be considered, not only to improve the ipsilateral hemispheric circulation but also the collateral circula-tion to the contralateral hemisphere, to prevent new ischemic cerebrovascular events.
Karger_ESC London_2013
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