Endovascular management of chronic internal carotid occlusion with Penumbra system

Carotid occlusion is a common disease and its incidence is about 6 in 100000. Annual risk of stroke is between 3% and 10% in older than 60 years with carotid occlusion and recurrent ischemic event have been reported in 25% of symptomatic carotid occlusion.1 Since many years ago it has been advocated in complete arterial occlusion, there was no chance for emboli to pass into the distal circulation. Therefore, a complete occlusion of the internal carotid artery (ICA) has been regarded as no need to follow-up and the natural history and optimal management of this condition remain undetermined up to now.