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Angiology: Open Access
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Giuseppe Nicoletti1* and Sandro Sanguigni2

1Division of Geriatric Medicine, Madonna delle Grazie Hospital, Matera, Italy

2Division of Neurology, Madonna del Soccorso Hospital, 63074 San Benedetto del Tronto, Ascoli Piceno, Italy

*Corresponding Author:
Dr.Giuseppe Nicoletti MD
Division of Geriatric Medicine
Madonna delle Grazie Hospital
75100 Matera, Italy
Tel: +39-360757137
E-mail: [email protected]

Received date: May 08, 2015; Accepted date: August 21, 2015; Published date: August 28, 2015

Citation: Nicoletti G, Sanguigni S (2015) Early Spontaneous Recanalization of Internal Carotid Artery Occlusion. Angiol 3:153. doi: 10.4172/2329-9495.1000153

Copyright: © 2015 Nicoletti G, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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A 70-year-old male was admitted with a history of malignant disease diagnosed 3 years before. Two days after admission the patient became confused and presented with right-sided weakness and aphasia. Color-coded duplex ultrasonography of the cerebral vessels was immediately performed showing occlusion of the origin of the left internal carotid artery (Figure 1A). About 30 minutes later the patient showed spectacular shrinking deficit, and color-coded duplex ultrasonography of the cerebral vessels showed recanalization of the left carotid artery (Figure 1 B). CT showed no alterations in brain density. At follow-up after 7 and 30 days, color Doppler US showed persistent patency of the vessel lumen. The cause of this occlusion may have been cardiac embolism, plaque rupture with consequent thrombosis, vessel dissection with hematoma, embolism of paraneoplastic origin. Knowledge about dynamic vessel wall changes during the hyperacute phase of cerebrovascular diseases requires immediate neurovascular imaging and close follow-up. Detection of a cerebral vessel occlusion depends mainly on the time elapsed from clinical onset to the initial vascular evaluation. Several studies showed that early spontaneous recanalization infrequently occurs during the first few hours of acute stroke [1,2]. In the cerebral vessels examination color-coded duplex ultrasonography offers a clinical tool that can localize occlusion and detect recanalization in real time. It is non-invasive and low cost; furthermore it allows study of hemodynamics at the patient’s bedside and follow up investigations are easily possible [3].


Figure 1A: Extracranial duplex, longitudinal plane (B-mode image): the narrowed lumen of the left carotid internal artery is completely filled with moderately echoic material.


Figure 1B: Extracranial duplex, longitudinal plane (B-mode image) 30 minutes later: spontaneous recanalization of the left carotid artery.


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