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Using PET to identify carotid occlusion patients at high risk of subsequent stroke: further insights

Department of Clinical Neurosciences and Stroke Unit, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK

Correspondence to:
Correspondence to:
J-C Baron
Department of Clinical Neurosciences and Stroke Unit, University of Cambridge, Addenbrooke’s Hospital, Box 83, Cambridge, CB2 2QQ, UK

Keywords: Keywords: carotid occlusion; positron emission tomography; stroke

The first 150 words of the full text of this article appear below.

Although atherothrombotic occlusion of the internal carotid artery (ICA) can cause a devastating stroke, in many instances it is a benign event, causing only transient ischaemic attacks (TIAs), a minor stroke, or even no symptom at all. Despite optimal medical treatment, however, the subsequent risk of stroke in patients with symptomatic ICA occlusion is around 7% per year, with 6% ipsilateral. It would be important to be able to identify patients at high risk of subsequent stroke to implement appropriate prevention. Studies performed over the last two decades have provided strong evidence that haemodynamic factors play a major role in such risk. The association of focally decreased cerebral blood flow (CBF) and increased oxygen extraction fraction (OEF)—coined "misery perfusion"—was first described in a patient with medically intractable TIAs distal to a previously documented ICA occlusion with poor collateralisation.¹ This abnormal physiology pointed to reduction in perfusion pressure beyond the . . . [Full text of this article]