Abstract
Occlusion of the intracranial distal internal carotid artery (ICA) is one of the most critical conditions among the cases of acute stroke in the anterior circulation. The introduction of selective endovascular treatment first using thrombolytic agents replaced later by the mechanical thrombectomy using various devices has improved the prognosis in a certain number of these patients. Among the factors influencing the prognosis of these patients, one is the collateral circulation which in these cases is mainly characterized by leptomeningeal anastomoses. The collateral can, however, be impaired, by distal embolization and by anomalies of the Circle of Willis: the aim of this study is to describe these aspects.
Similar content being viewed by others
References
Zeumer H, Freitag HJ, Zanella F, Thie A, Arning C. Local intra-arterial fibrinolytic therapy in patients with stroke: urokinase versus recombinant tissue plasminogen activator (r-TPA). Neuroradiology. 1993;35:159–62.
Urbach H, Ries F, Ostertun B, Solymosi L. Local intra-arterial fibrinolysis in thromboembolic “T” occlusions of the internal carotid artery. Neuroradiology. 1997;39:105–10.
Zaidat OO, Suarez JI, Santillan C, Sunshine JL, Tarr RW, Paras VH, Selman WR, Landis DM. Response to intra-arterial and combined intravenous and intra-arterial thrombolytic therapy in patients with distal internal carotid artery occlusion. Stroke. 2002;33:1821–6.
Arnold M, Nedeltchev K, Mattle HP, Loher TJ, Stepper F, Schroth G, Brekenfeld C, Sturzenegger M, Remonda L. Intra-arterial thrombolysis in 24 consecutive patients with internal carotid artery T occlusions. J Neurol Neurosurg Psychiatry. 2003;74:739–42.
Jansen O, Von Kummer R, Forsting M, Hacke W, Sartor K. Thrombolytic therapy in acute occlusion of the intracranial internal carotid artery bifurcation. AJNR Am J Neuroradiol. 1995;16:1977–86.
Song JK, Cacayorin ED, Campbell MS, Fisher S, Malkoff MD, Alexandrov AV, Grotta JC. Intracranial balloon angioplasty of acute terminal internal carotid artery occlusions. AJNR Am J Neuroradiol. 2002;23:1308–12.
Flint AC, Duckwiler GR, Budzik RF, Liebeskind DS, Smith WS; MERCI and Multi MERCI Writing Committee. Mechanical thrombectomy of intracranial internal carotid occlusion: pooled results of the MERCI and Multi MERCI Part I trials. Stroke. 2007;38:1274–80.
Lin R, Vora N, Zaidi S, Aleu A, Jankowitz B, Thomas A, Gupta R, Horowitz M, Kim S, Reddy V, Hammer M, Uchino K, Wechsler LR, Jovin T. Mechanical approaches combined with intra-arterial pharmacological therapy are associated with higher recanalization rates than either intervention alone in revascularization of acute carotid terminus occlusion. Stroke. 2009;40:2092–7.
Castaño C, Dorado L, Guerrero C, Millán M, Gomis M, Perez de la Ossa N, Castellanos M, García MR, Domenech S, Dávalos A. Mechanical thrombectomy with the Solitaire AB device in large artery occlusions of the anterior circulation: a pilot study. Stroke. 2010;41:1836–40.
Machi P, Costalat V, Lobotesis K, Maldonado IL, Vendrell JF, Riquelme C, Bonafé A. Solitaire FR thrombectomy system: immediate results in 56 consecutive acute ischemic stroke patients. J Neurointerv Surg. 2012;4:62–6.
Brekenfeld C, Schroth G, Mordasini P, Fischer U, Mono ML, Weck A, Arnold M, El-Koussy M, Gralla J. Impact of retrievable stents on acute ischemic stroke treatment. AJNR Am J Neuroradiol. 2011;32:1269–73.
Fesl G, Wiesmann M, Patzig M, Holtmannspoetter M, Pfefferkorn T, Dichgans M, Brueckmann H. Endovascular mechanical recanalization of acute carotid “T” occlusion. A single-center retrospective analysis. Cardiovasc Intervent Radiol. 2011;34:280–6.
Möhlenbruch M, Seifert M, Okulla T, Wüllner U, Hadizadeh DR, Nelles M, Greschus S, Wilhelm K, Schild HH, Klockgether T, Urbach H. Mechanical thrombectomy compared to local-intraarterial thrombolysis in carotid T and middle cerebral artery occlusions: a single center experience. Clin Neuroradiol. 2012;22:141–7.
Dorn F, Stehle S, Lockau H, Zimmer C, Liebig T. Endovascular treatment of acute intracerebral artery occlusions with the solitaire stent: single-centre experience with 108 recanalization procedures. Cerebrovasc Dis. 2012;34:70–7.
Dávalos A, Pereira VM, Chapot R, Bonafé A, Andersson T, Gralla J; Solitaire Group. Retrospective multicenter study of Solitaire FR for revascularization in the treatment of acute ischemic stroke. Stroke. 2012;43:2699–705.
Behme D, Gondecki L, Fiethen S, Kowoll A, Mpotsaris A, Weber W. Complications of mechanical thrombectomy for acute ischemic stroke—a retrospective single-center study of 176 consecutive cases. Neuroradiology. 2014;56:467–76.
Berkhemer OA, Fransen PS, Beumer D, van den Berg LA, Lingsma HF, Yoo AJ, Schonewille WJ, Vos JA, Nederkoorn PJ, Wermer MJ, van Walderveen MA, Staals J, Hofmeijer J, van Oostayen JA, Lycklama à Nijeholt GJ, Boiten J, Brouwer PA, Emmer BJ, de Bruijn SF, van Dijk LC, Kappelle LJ, Lo RH, van Dijk EJ, de Vries J, de Kort PL, van Rooij WJ, van den Berg JS, van Hasselt BA, Aerden LA, Dallinga RJ, Visser MC, Bot JC, Vroomen PC, Eshghi O, Schreuder TH, Heijboer RJ, Keizer K, Tielbeek AV, den Hertog HM, Gerrits DG, van den Berg-Vos RM, Karas GB, Steyerberg EW, Flach HZ, Marquering HA, Sprengers ME, Jenniskens SF, Beenen LF, van den Berg R, Koudstaal PJ, van Zwam WH, Roos YB, van der Lugt A, van Oostenbrugge RJ, Majoie CB, Dippel DW; MR CLEAN Investigators. A randomized trial of intraarterial treatment for acute ischemic stroke. N Engl J Med. 2015;372:11–20.
Khatri P, Abruzzo T, Yeatts SD, Nichols C, Broderick JP, Tomsick TA; IMS I and II Investigators. Good clinical outcome after ischemic stroke with successful revascularization is time-dependent. Neurology. 2009;73:1066–72.
Bang OY, Saver JL, Kim SJ, Kim GM, Chung CS, Ovbiagele B, Lee KH, Liebeskind DS. Collateral flow predicts response to endovascular therapy for acute ischemic stroke. Stroke. 2011;42:693–9.
Liebeskind DS, Flint AC, Budzik RF, Xiang B, Smith WS, Duckwiler GR, Nogueira RG; MERCI and Multi-MERCI Investigators. Carotid I’s, L’s and T’s: collaterals shape the outcome of intracranial carotid occlusion in acute ischemic stroke. J Neurointerv Surg. 2015;7:402–7.
Noqueira RG, Yoo AJ, Buonanno FS, Hirsch JA. Endovascular approaches to acute stroke, part 2: a comprehensive review of studies and trials. AJNR Am J Neuroradiol. 2009;30:859–75.
Bradac GB. Cerebral angiography, normal anatomy and vascular pathology. 2nd ed., Berlin: Springer; 2014.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Bradac, G.B., Venturi, F., Stura, G. et al. Considerations about Occlusion of the Intracranial Distal Internal Carotid Artery. Clin Neuroradiol 27, 169–174 (2017). https://doi.org/10.1007/s00062-015-0480-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00062-015-0480-1