Predictive value of preoperative flow parameters for successful recanalization of an internal carotid artery pseudoocclusion

Introduction: According to a pooled evaluation of randomized trials, patients with a symptomatic high-grade internal carotid stenosis and a poststenotic arterial narrowing (pseudoocclusion) do not benefit from carotid surgery. Although not examined explicitly in those randomized trials, these results may only be valid for well-collateralized stenoses. Due to insufficient collateralization, hemodynamically critical patients bear a very high risk of a recurrent stroke and should be recanalized early after their first ischemic event. In those patients the recanalization of a pseudoocclusion is not always successful…