This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Estol, C. J. Search for Related Content PubMed PubMed Citation Articles by Estol, C. J.

(Stroke. 1996;27:559-566.)
© 1996 American Heart Association, Inc.

Articles

Dr C. Miller Fisher and the History of Carotid Artery Disease

Conrado J. Estol, MD, PhD

From the Instituto Cardiovascular de Buenos Aires (Argentina).

Correspondence to Conrad J. Estol, MD, PhD, Cerebrovascular Disease Section, Instituto Cardiovascular de Buenos Aires, Blanco Encalada 1543, 1428 Buenos Aires, Argentina.

Background and Purpose Our aim was to analyze the role that C. Miller Fisher (C.M.F.) had in promoting an understanding of carotid artery disease (CAD). Although Chiari in 1905 and later Hunt, Moniz, and Hultquist, among others, described the association of CAD and stroke, this received little attention until C.M.F. published his clinicoanatomic correlations in "Occlusion of the Carotid Arteries." Until then, some 55% of strokes were attributed to "vasospasm."

Methods We analyzed articles ("Occlusion of the Internal Carotid Artery," 1951; "Occlusion of the Carotid Arteries," 1954; "Transient Monocular Blindness Associated With Hemiplegia," 1952; "The Microembolic Theory of Transient Ischemic Attacks," 1976; "A Clinico-pathologic Study of Carotid Endarterectomy Plaques," 1986) and conducted personal interviews with C.M.F.

Results During the 1950s, C.M.F. described the clinical implications of transient ischemic attacks and their relationship to CAD and stroke. The last sentence in the 1951 article read: "Unexplained cerebral embolism may arise from thrombotic material lying in the carotid sinus." In the same article he also wrote that "it is even conceivable that some day vascular surgery will find a way to by-pass the occluded portion of the artery during the period of ominous fleeting symptoms," heralding the future surgical treatment of carotid artery disease. C.M.F. called attention to the commonness of carotid disease, described transient monocular blindness, and studied the relationship between plaque pathology and clinical findings.

Conclusions C.M.F.'s clinicopathologic observations were a major factor in promoting recognition of the clinical features, stroke risk, and treatment of CAD.

Key Words: carotid artery diseases • carotid endarterectomy • history

This article has been cited by other articles:

				C M Ashton, N P Wray, A F Jarman, J M Kolman, D M Wenner, and B A Brody Ethics and methods in surgical trials J. Med. Ethics, September 1, 2009; 35(9): 579 - 583. [Abstract] [Full Text] [PDF]

				P. A. Tunick and I. Kronzon Atheromas of the thoracic aorta: clinical and therapeutic update J. Am. Coll. Cardiol., March 1, 2000; 35(3): 545 - 554. [Abstract] [Full Text] [PDF]

				N. Suwanwela, U. Can, K. L. Furie, J. F. Southern, N. R. Macdonald, C. S. Ogilvy, C. J. Hansen, F. S. Buonanno, W. M. Abbott, W. J. Koroshetz, et al. Carotid Doppler Ultrasound Criteria for Internal Carotid Artery Stenosis Based on Residual Lumen Diameter Calculated From En Bloc Carotid Endarterectomy Specimens Stroke, November 1, 1996; 27(11): 1965 - 1969. [Abstract] [Full Text]