[Therapy of carotid stenosis in contralateral occlusion of the internal carotid artery].

From January 1985 up to December 1987 sixteen patients with unilateral stenosis of the internal carotid artery (ICA) and concomitant chronic contralateral carotid occlusion underwent surgical correction of the stenosis. 31.2% were asymptomatic, 18.7% had transient ischemic attacks and 50% had suffered a stroke. On the occluded side 31.2% had had a stroke. Angiography showed intracerebral shunting to the occluded side in 43.7%; 56.2% of the patients had concomitant stenoses of intracerebral vessels. Surgical correction consisted of endarterectomy and patch-plasty of the ICA-stenosis in local anesthesia under protection of an intraluminal shunt. There was no mortality and no perioperative stroke. After a mean interval of 32 months life table analysis showed a stroke-free rate of 92% from 6 to 24 months on the operated side and of 84% from 12 to 24 months on the occluded side. We conclude that ICA-endarterectomy in patients with contralateral ICA-occlusion can be done without increased perioperative risk and yields satisfactory long time results.