Surgery of acute occlusion of the extracranial internal carotid artery - a meta-analysis.

Abstract

Acute occlusion of the extracranial internal carotid artery (eICA) is associated with poor prognosis. Surgical desobliteration has not received adequate attention in recent years. We therefore conducted a literature review and meta-analysis of surgical studies published after 2000 that treated eICA occlusion surgically in an emergency setting. The search identified 10 relevant articles that included a total of 175 patients. The outcomes analysed included rates of recanalization (93%), early neurological improvement (66%), modified Rankin Scale 0-2 (62%), mortality (5%), early reocclusion (4%), in-hospital stroke (4%) and symptomatic intracerebral haemorrhage (4%). In conclusion, acute surgical desobliteration of eICA occlusion leads to high rates of recanalization and a majority of patients experience early neurological improvement and achieve favourable outcome. Rates of mortality, early reocclusion, in-hospital stroke and sICH are acceptable in the view of unfavourable natural history.