Ah, war stories ...
In 1976-77 - male presenting with multiple episodes per day of Lt amaurosis
fugax. Doppler findings included Lt ICA occlusion with retrograde Lt periorbital
& ophthalmic arteries (with moderate proximal L ECA stenosis). Arteriography
confirmed Lt ICA occlusion with stump (included most of the ICA bulb) and Lt
external to internal collateralization via the Lt ophthalmic artery (as well as
proximal Lt ECA stenosis). Medical management associated with an increase in
frequency and duration of episodes of amaurosis fugax. Surgery included
endarterectomy of the Lt CCA - ECA with ligation of the proximal Lt ICA stump.
Symptoms resolved for approximately three months after which the surgeon, in an OR
discussion, noted recurrence of the patient's symptoms ... pt lost to followup (as
I recall, he was very unwilling to have another select injection multiple view
arteriogram - not an uncommon reaction at the time). In any case, I seriously
doubt the surgeon would have been inclined to perform another procedure.
Otherwise, I cannot say that I've seen a TIA/CVA that was known secondary to ECA
stenosis - but would not completely discount the possibility IF the ECA is
providing perfusion to the brain - but recognize the magnitude of the "IF".
/fww
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Fellow Flownetters!
Has anyone read anything describing TIA or CVA from a high grade ECA stenosis? A
physician has stated to me that you can get TIA's or CVA's
from an ECA with high grade stenosis. ( Right ICA peak 116, Left ICA
peak 76 cm/sec) Need some lit to support his claim. I wanted him to change his
report from claiming "critical ECA stenosis, " because most PCP's would send
that patient to a vascular surgeon based on that report. Thanks in advance for
your help!
Barb
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