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There is a general agreement that symptomatic patients with high-grade stenosis of internal carotid artery (ICA) should be treated with either surgery or percutaneous intervention.[1,2] On the other hand, there is considerable controversy with respect to the approach to the patients with near total ICA occlusion. These patients are considered to be at lower risk for transient ischemic attack (TIA), stroke, and death than patients with a lesser degree of stenosis. [3] There are no prospective randomized clinical trials dealing with this issue, and the available data mostly originate from the post-hoc analysis of the large trials performed in the late 1990s. The results of these studies are conflicting and provide little benefit in clinical decision making. [4,5] Therefore, the aim of the present study was to prospectively evaluate clinical effects of eversion carotid endarterectomy (ECEA) versus best medical treatment of symptomatic patients with near total ICA occlusion.

intech ebooks

Eversion Carotid Endarterectomy in Patients with Near-Total Internal Carotid Artery Occlusion - Diagnostic Modalities, Indications and Surgical Technique