Key result
Carotid near-occlusion, defined as distal internal carotid artery luminal collapse beyond a tight stenosis, requires careful diagnosis with CTA to avoid misclassification as conventional stenosis or total occlusion.
Systematic Review
This systematic review standardizes the terminology of carotid near-occlusion into 'with' and 'without full collapse' and recommends CTA with delayed imaging over sonography for accurate diagnosis.
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Alerts clinicians to CTA pitfalls in near-occlusion; extends standards by formalizing collapse subtypes and CTA protocols.
Carotid near-occlusion is distal ICA luminal collapse beyond a tight stenosis, where the distal lumen should not be used for calculating percentage stenosis. Near-occlusion with full ICA collapse is well-known, with a threadlike lumen. However, near-occlusion without collapse is often subtle and can be overlooked as a usual severe stenosis. More than 10 different terms have been used to describe near-occlusion, sometimes causing confusion. This systematic review presents what is known about carotid near-occlusion. In this first part, the foci are definition, terminology, and diagnosis.
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Johansson et al. (2015) conducted a systematic review in Carotid near-occlusion. Diagnostic imaging (CTA, conventional angiography, sonography, MRA) was evaluated. Carotid near-occlusion, defined as distal internal carotid artery luminal collapse beyond a tight stenosis, requires careful diagnosis with CTA to avoid misclassification as conventional stenosis or total occlusion.
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