XXXVI.l When Should We Attempt to Open an Occluded Carotid or Vertebral Artery? How Should It Be Done?

摘要

During this presentation, the authors' indications for and techniques of revascularization of occluded extracranial arteries will be described. Illustrative cases will be shown to demonstrate these techniques and the angiographic and clinical results.At our center, we are very selective in attempts to revascularize an occluded carotid or vertebral artery. The patient with an acute occlusion should have little stroke burden demonstrated on radiological studies such as magnetic resonance imaging or computed tomo-graphic perfusion scanning. A substantial stroke burden will increase the likelihood of intracranial reperfusion hemorrhage, and acute revascularization should not be considered in this setting, especially if the patient's neurological examination is relatively good. On the other hand, a fluctuating examination or a moderate deficit in the absence of a large stroke seen on radiological studies is appropriate for revascularization in the setting of acute occlusion.