Treatment of the totally occluded carotid artery
B. P. Jordan, D. T. Mayschak and M. W. Flye
Thirty-four patients, each with a totally occluded common or internal
carotid artery, were treated over a 15-year period. Seventeen patients were
treated nonsurgically, 17 underwent surgery. There were four patients in
the nonsurgical group and six patients in the surgical group who were
followed up until death. The average time span from diagnosis of carotid
occlusion until death was 4.75 years in the nonsurgical group and 4.52
years in the surgical group. In the nonsurgical group, recurrent symptoms
of cerebrovascular accident (CVA) developed in 60% of the patients
available for extended follow-up. In contrast, 14% of the patients operated
on and available for follow-up had recurrent symptoms, and no CVAs occurred
postoperatively. From our data, we concluded that the stroke-free interval
is improved, whereas survival is unaffected in the surgically treated
patient. Endarterectomy of a contralateral stenotic carotid artery is
particularly successful in achieving this reduction in morbidity.
