RECANALIZATION OF OCCLUDED INTERNAL CAROT ID-ARTERY

There is controversy over the suggestion that recanalisation of extrac ranially occluded internal carotid arteries (ICAs) is more frequent th an actually documented, A follow-up of thirty patients with sonographi cally (n = 31) and angiographically (n = 29) verified occlusion of the ICA was performed at median 401 days after occlusion. In 24 cases, th e occlusion was due to arteriosclerosis and thrombosis; in three cases due to macroembolism; in three cases due to dissection and in one cas e due to exogenous trauma. 16 patients received an anticoagulant thera py with intravenous heparin (25 000 IE/d). In three patients with arte riosclerotic-thrombotic or embolic occlusion of the ICA partial or com plete recanalisation was found 18 days, 37 days and 16 years respectiv ely after the initial diagnosis. Two of them received high-dose intrav enous heparin. Two patients with occlusions due to dissection showed n early normalized recanalisation. They were treated with high-dose hepa rin, Our results show that recanalisation of an occluded carotid arter y due to arteriosclerosis and thrombosis or macroembolism is possible but rare. Treatment with high-dose heparin does not lead to better rec analisation. Occlusion due to dissection shows a higher rate of recana lisation.