caa a22 4500 606215972 CHVBK 20210128101101.0 cr unu---uuuuu 210128e20150801xx s 000 0 eng 10.1007/s00701-015-2478-5 doi (NATIONALLICENCE)springer-10.1007/s00701-015-2478-5 Emergent cervical surgical embolectomy for extracranial internal carotid artery occlusion [Elektronische Daten] [Satoshi Kiyofuji, Tomohiro Inoue, Akira Tamura, Isamu Saito] Background: Acute extracranial internal carotid artery (ICA) occlusion by a huge cardiogenic embolus is rare, but can be catastrophic. Methods: Seven patients with acute ischemic stroke due to embolic occlusion of extracranial ICA who underwent emergent cervical surgical embolectomy were retrospectively reviewed. Diagnosis was made in six patients with magnetic resonance imaging (MRI) with optional digital subtraction angiography (DSA), while computed tomography (CT) and DSA were used in one patient with an implanted pacemaker. Clinical outcomes, including recanalization rate, recanalization time, complications, modified Rankin scale (mRS) at 3months, and National Institute of Health Stroke Scale (NIHSS) score improvement at 1month were evaluated. Results: Complete recanalization was obtained in seven patients (100%). Median recanalization time from symptom onset and from start of surgery was 402 and 40min, respectively. All seven patients showed severe left ventricular hypertrophy (LVH) according to an increased cardiothoracic ratio (CTR) ≥50%. Complications included recurrence of cardioembolic stroke with the right middle cerebral artery occlusion, minimal expansion of infarction, and aggravation of heart failure, each in one patient, respectively. Four (57.1%) patients had a history or postoperative recurrence of cardioembolic stroke. Median NIHSS at 1month was 2 (range, 0-30). Median mRS at 3months was 2 (range, 0-5). Five patients (71.4%) had a favorable outcome (mRS2). Conclusions: Cervical surgical embolectomy for acute extracranial ICA occlusion resulted in a high complete recanalization rate with an acceptable safety profile. A possible association between severe cardiac illness and huge embolus occluding proximal large artery was suggested. Springer-Verlag Wien, 2015 Acute ischemic stroke nationallicence Atrial fibrillation nationallicence Cardiogenic embolism nationallicence Carotid occlusion nationallicence Surgical embolectomy nationallicence Kiyofuji Satoshi Department of Neurosurgery, Fuji Brain Institute and Hospital, Fujinomiya City, 270-12 Sugita, 418-0021, Fujinomiya City, Shizuoka, Japan aut Inoue Tomohiro Department of Neurosurgery, Fuji Brain Institute and Hospital, Fujinomiya City, 270-12 Sugita, 418-0021, Fujinomiya City, Shizuoka, Japan aut Tamura Akira Department of Neurosurgery, Fuji Brain Institute and Hospital, Fujinomiya City, 270-12 Sugita, 418-0021, Fujinomiya City, Shizuoka, Japan aut Saito Isamu Department of Neurosurgery, Fuji Brain Institute and Hospital, Fujinomiya City, 270-12 Sugita, 418-0021, Fujinomiya City, Shizuoka, Japan aut Acta Neurochirurgica Springer Vienna 157/8(2015-08-01), 1313-1319 0001-6268 157:8<1313 2015 157 701 https://doi.org/10.1007/s00701-015-2478-5 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-015-2478-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kiyofuji Satoshi Department of Neurosurgery, Fuji Brain Institute and Hospital, Fujinomiya City, 270-12 Sugita, 418-0021, Fujinomiya City, Shizuoka, Japan aut NATIONALLICENCE 700 1- Inoue Tomohiro Department of Neurosurgery, Fuji Brain Institute and Hospital, Fujinomiya City, 270-12 Sugita, 418-0021, Fujinomiya City, Shizuoka, Japan aut NATIONALLICENCE 700 1- Tamura Akira Department of Neurosurgery, Fuji Brain Institute and Hospital, Fujinomiya City, 270-12 Sugita, 418-0021, Fujinomiya City, Shizuoka, Japan aut NATIONALLICENCE 700 1- Saito Isamu Department of Neurosurgery, Fuji Brain Institute and Hospital, Fujinomiya City, 270-12 Sugita, 418-0021, Fujinomiya City, Shizuoka, Japan aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/8(2015-08-01), 1313-1319 0001-6268 157:8<1313 2015 157 701