ATHEROMATOUS PSEUDO-OCCLUSION OF THE INTE RNAL CAROTID-ARTERY

Pseudo-occlusion of the internal carotid artery is defined as an angio graphically occluded but anatomically patent artery. Between january 1 980 and december 1990, 14 cases were diagnosed in our institution. Pre operative Doppler examination of the internal carotid artery suggested almost complete thrombosis in 11 patients and occlusion in 3. The ang iographic appearance suggested internal carotid occlusion in all but t he presence of the slim sign was in favor of a patent artery. All 14 p atients underwent surgery. There were no postoperative deaths ; one pa tient presented an ipsilateral TIA post operatively ; 3 others present ed an ipsilateral TIA after 2, 16 and 30 months respectively. All caro tid arteries were found to be patent. The frequency of pseudo-occlusio n of the internal carotid artery is probably understimated. It must be kept in mind whenever an apparently occluded internal carotid continu es to be symptomatic. Diagnosis is based on comparative analysis of Do ppler examination and angiographic findings. Surgery is indicated when ever doubt persists (J Mal Vasc, 1993, 18, p. 233-237).