Intraluminal XXXX in the cerebral circulation. Implications for surgical management.

@entity1 @entity64 @entity5892 @entity63 @entity731 @entity1003 @entity1188 @entity715 @entity850
Thrombi defined as intraluminal filling defects detected by angiography were identified in 30 @entity1 (29 in the carotid system, one in the vertebral artery). @entity64 was the presentation ipsilateral to the @entity715 in 22 @entity1 (12 had previous transient @entity63 attacks), transient @entity63 attacks occurred alone in seven cases, and one @entity1 was asymptomatic. Angiography revealed a severe @entity850 in association with the @entity715 in 23 @entity1 , a moderate @entity850 in four @entity1 , and, in the three @entity1 with only minimal @entity850 presumably due to @entity731 , there was evidence for a @entity1003 . Sixteen of the 30 @entity1 were operated on urgently, 10 within 24 hours of detection of the @entity715 . Twelve of these 16 surgical @entity1 were given anticoagulation before surgery. At endarterectomy, @entity715 was identified in 11 of the 14 surgical @entity1 in whom the @entity715 was accessible; the other two surgical @entity1 had @entity5892 only. In this group, four of 11 surgical @entity1 with accessible thrombi suffered perioperative episodes of new or larger @entity1188 . Fourteen of the 30 @entity1 initially received medical management with no complication. Eight of these 14 medical @entity1 had repeat angiography; seven exhibited complete resolution of @entity715 , and six of these seven @entity1 subsequently underwent delayed endarterectomy for the @entity850 . No @entity715 was identified at surgery in any of the six. One of the six delayed surgery @entity1 suffered a perioperative @entity64 . Although these numbers are small, reflecting the rarity of @entity715 demonstrated by angiography, undetected @entity715 is often found at endarterectomy. Its presence may increase operative risk.(ABSTRACT TRUNCATED AT 250 WORDS)
