Carotid ultrasound findings among patients successfully treated with endovascular thrombectomy for atherosclerotic internal carotid artery origin occlusion

Abstract

Background and Purpose: Treatment strategy using endovascular thrombectomy (EVT) for atherosclerotic internal carotid artery (ICA) occlusion at the original segment has not been established. We hypothesized that carotid ultrasound may detect the portion where guidewire can penetrate the atherosclerotic ICA origin occlusion. Methods: From our EVT registry, data on patients with atherosclerotic ICA origin occlusion who were examined using carotid ultrasound and successfully treated using EVT between April 2015 and May 2019 were retrospectively analyzed. Only patients in whom carotid ultrasound was able to detect the portion where guidewire penetrated were analyzed. Results: 6 patients were analyzed. Carotid ultrasound demonstrated the portion as hypoechogenic lesion, distinguished from surrounding hyperechogenic and isoechogenic lesions. Color Doppler clearly showed the blood flow signal entering to the hypoechogenic lesion in 3 patients. The lesion where guidewire penetrated was located at the frontal side of the ICA near the external carotid artery. Conclusion: Ultrasound examinations may detect the occlusive portion where the guidewire can penetrate.