Fig 2.

Successful recanalization of a left chronic ICA occlusion (case 4). A 78-year-old man with recurrent episodes of transient right hemiparesis underwent recanalization at 6 months after the initial diagnosis of left ICA occlusion. A–C, Lateral projections of the left carotid angiogram. A, Before treatment, the occlusive lesion extends from the cervical segment to the petrous segment of the ICA. B, Just after the recanalization. C, One-year follow-up. D, DWI obtained 1 day after the procedure. Asymptomatic small ischemic lesions ≤9 mm are detected in the ipsilateral side of the recanalized ICA and in the contralateral side. E and F, SPECT images with acetazolamide vasodilatory challenge before and 13 months after the procedure, respectively. Severe impairment of the left cerebral hemispheric vascular reserve improved after successful recanalization of the ipsilateral ICA.