Population-based study of symptomatic internal carotid artery occlusion: incidence and long-term follow-up

Stroke; a Journal of Cerebral Circulation
Matthew L FlahertyRobert D Brown

Abstract

Internal carotid artery (ICA) occlusion is an important cause of transient ischemic attack (TIA) and cerebral infarction. There are no previous population-based natural history studies evaluating outcome after symptomatic ICA occlusion (SICAO). We performed a retrospective, population-based study of SICAO. All Olmsted County (Minnesota) residents with possible SICAO from 1986 to 2000 were identified by cross-referencing appropriate clinical and imaging codes. Inclusion criteria were cerebral infarction or TIA in a carotid distribution and imaging documentation of ipsilateral ICA occlusion <3 months after the index event. Kaplan-Meier estimates were used to calculate the risk of cerebral infarction, myocardial infarction, and death after SICAO. Seventy-five patients qualified. Annual SICAO incidence was 6 per 100,000 persons (age and gender adjusted to the 2000 US white population). Risk of cerebral infarction during follow-up was 8% at 30 days, 10% at 1 year, and 14% at 5 years. Five of 11 cerebral infarctions occurred within the first week after diagnosis of occlusion. Risk of myocardial infarction was 0% at 30 days, 8% at 1 year, and 24% at 5 years. Risk of death was 7%, 13%, and 29%, respectively. There may be 15,000 to 20,0...Continue Reading

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