COMMON CAROTID-ARTERY OCCLUSION - EVALUATION WITH DUPLEX SONOGRAPHY

PURPOSE: To demonstrate the efficacy of carotid duplex ultrasound to d iagnose common carotid artery occlusion (CCAO) and to define the clini cal features of CCAO. METHODS: We reviewed 5400 carotid duplex ultraso nograms obtained over a 7-year period for suspected carotid artery dis ease. In cases of CCAO, medical records were reviewed. RESULTS: Thirte en cases (0.24%) of CCAO were diagnosed by carotid duplex ultrasonogra phy, including five cases of isolated CCAO. Seven cases were proved by cerebral angiography. Cerebral angiography failed to demonstrate pate nt internal carotid arteries in two cases of isolated CCAO. Mean age o f onset was 67 +/- 9 years. The main clinical presentation was stroke in nine cases (69%). The most common vascular risk factors were hypert ension (62%) and heart diseases (54%). Three patients had a history of radiation therapy to the neck. Two of five patients with isolated CCA O had major stroke, with good recovery in one, whereas five of eight p atients with CCAO had major stroke; among them, only one had good reco very. CONCLUSION: Patients with isolated CCAO may have a better outcom e than patients with CCAO. Duplex sonography, particularly with color- coded Bow imaging, provides an accurate examination to define the pate ncy of the arteries distal to the carotid bifurcation. The clinical fe atures of CCAO are similar to those of internal carotid artery occlusi on except for the low prevalence of CCAO.