Internal carotid occlusion: a prospective study.

Forty-seven patients with ICA occlusion and who presented either without any or only a mild neurological deficit were prospectively followed for an average of 34.4 months. During this period of time, 11 patients (23.5%) suffered a cerebral infarction of which two-thirds were ipsilateral to the occluded artery. The stroke rate distal to an occluded ICA artery was 5% per year. Twenty-four patients (51%) continued to experience TIA's in the territory of the occluded artery. The mortality rate was low (8.5%) during follow-up. Whether extracranial-intracranial bypass surgery will decrease the risk of cerebral infarction in this subgroup of patients is unknown. The International EC/IC Collaborative Trial may elucidate this point because this subgroup represents one of the randomization strata of that study.