Stroke, Vol 9, 448-456, Copyright © 1978 by American Heart Association
HJ Barnett, SJ Peerless and JC Kaufmann
A series of 9 patients have experienced hemisphere and retinal ischemia at
an interval after occlusion of appropriate internal carotid arteries. All
had radiological evidence of a persisting proximal stump to the occluded
artery and, in most, pathological evidence of thrombotic material attached
to atheromatous lesions within the stump. Thromboembolism from the stump
via the anastomotic supply through ipsilateral common and external carotid
arteries is thought to be responsible for the ischemic events to the brain
or retina despite absence of flow through the internal carotid artery.
Seven of the 9 were treated by surgical excision or obliteration of the
stump and, when indicated, common and external carotid endarterectomy.
Turbulence in the stump contributed to progressive atherosclerotic changes
and probably aggravated thrombogenesis in this location with subsequent
embolization into the anastomotic arteries.
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"Stump" on internal carotid artery--a source for further cerebral embolic ischemia
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