{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T03:58:56Z","timestamp":1781668736039,"version":"3.54.5"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2011,8]]},"abstract":"\nObject<\/jats:title>\nThis study describes clinicopathological characteristics of pseudo-occlusion of the internal carotid artery with regard to its possible mechanisms.<\/jats:p><\/jats:sec>\n\nMethods<\/jats:title>\nThe authors retrospectively reviewed 17 patients with pseudo-occlusion and 23 with high-grade stenosis (North American Symptomatic Carotid Endarterectomy Trial criteria \u2265 90%, but no collapsed distal internal carotid artery) who underwent carotid endarterectomy. Atherosclerotic risk factors, clinical presentation, angiographic findings, and histological features of plaque obtained from the carotid endarterectomy were investigated and comparisons were made between groups.<\/jats:p><\/jats:sec>\n\nResults<\/jats:title>\nPlaques obtained in the pseudo-occlusion group were significantly more fibrous and less atheromatous than those in the high-grade stenosis group. Old, organized thrombi were more frequently found in pseudo-occlusion group plaques than in high-grade stenosis group plaques. Plaques acquired in the pseudo-occlusion group had 2 different histological features: the presence or absence of the original lumen. The pseudo-occlusion plaques with total occlusion and recanalization (8 patients) were composed of thrombotic total occlusion with lumen recanalization by large neovascular channels, whereas those with severe stenosis (9 patients) were fibrous or fibroatheromatous and had severe stenosis of the original lumen. In patients with pseudo-occlusion and total occlusion and recanalization, the authors observed a significantly higher incidence of transient ischemic attack and anterior communicating artery\u2013posterior communicating artery collateral flow than those with high-grade stenosis and pseudo-occlusion with severe stenosis.<\/jats:p><\/jats:sec>\n\nConclusions<\/jats:title>\nPlaques of the pseudo-occlusion group were more fibrous than those of the high-grade stenosis group and had 2 different histological features: pseudo-occlusion with total occlusion and recanalization or pseudoocclusion with severe stenosis. This difference in plaque histology may be related to the clinical features of pseudoocclusion, such as symptoms and collateral flow patterns.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2011.3.jns101434","type":"journal-article","created":{"date-parts":[[2011,5,6]],"date-time":"2011-05-06T14:28:09Z","timestamp":1304692089000},"page":"350-358","source":"Crossref","is-referenced-by-count":19,"title":["Histopathological features with angiographic correlates of internal carotid artery pseudo-occlusion: impact of plaque compositions"],"prefix":"10.3171","volume":"115","author":[{"given":"Yoko","family":"Hirata","sequence":"first","affiliation":[{"name":"Departments of Pathology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriyuki","family":"Sakata","sequence":"additional","affiliation":[{"name":"Departments of Pathology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tooru","family":"Inoue","sequence":"additional","affiliation":[{"name":"Neurosurgery, Fukuoka University, Faculty of Medicine; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kotaro","family":"Yasumori","sequence":"additional","affiliation":[{"name":"Departments of Radiology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Yasaka","sequence":"additional","affiliation":[{"name":"Cerebrovascular Disease, National Hospital Organization, Kyusyu Medical Center, Fukuoka City, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasushi","family":"Okada","sequence":"additional","affiliation":[{"name":"Cerebrovascular Disease, National Hospital Organization, Kyusyu Medical Center, Fukuoka City, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns101434","series-title":"Surg Neurol","first-page":"222","article-title":"Acute pathologic features with angiographic correlates of the nearly or completely occluded lesions of the cervical internal carotid artery","volume":"46","author":"Endo","year":"1996"},{"key":"b2-jns101434","series-title":"AJNR Am J Neuroradiol","first-page":"2086","article-title":"Identification, prognosis, and management of patients with carotid artery near occlusion","volume":"26","author":"Fox","year":"2005"},{"key":"b3-jns101434","series-title":"Stroke","first-page":"476","article-title":"Implications of the angiographic string sign in carotid atherosclerosis","volume":"21","author":"Fredericks","year":"1990"},{"key":"b4-jns101434","series-title":"Stroke","first-page":"1852","article-title":"Diagnostic impact of transcranial color-coded real-time sonography with echo contrast agents for hyperperfusion syndrome after carotid endarterectomy","volume":"35","author":"Fujimoto","year":"2004"},{"key":"b5-jns101434","series-title":"Cerebrovasc Dis","first-page":"170","article-title":"Accuracy of conventional plus transoral carotid ultrasonography in distinguishing pseudo-occlusion from total occlusion of the internal carotid artery","volume":"22","author":"Fujimoto","year":"2006"},{"key":"b6-jns101434","series-title":"Stroke","first-page":"2671","article-title":"Circle of Willis collateral flow investigated by magnetic resonance angiography","volume":"30","author":"Hartkamp","year":"1999"},{"key":"b7-jns101434","series-title":"J Vasc Surg","first-page":"289","article-title":"Gender-associated differences in plaque phenotype of patients undergoing carotid endarterectomy","volume":"45","author":"Hellings","year":"2007"},{"key":"b8-jns101434","series-title":"Stroke","first-page":"1650","article-title":"Effect of carotid endarterectomy on primary collateral blood flow in patients with severe carotid artery lesions","volume":"34","author":"Hendrikse","year":"2003"},{"key":"b9-jns101434","series-title":"Eur J Vasc Endovasc Surg","first-page":"310","article-title":"Pseudo- and segmental occlusion of the internal carotid artery: a new classification, surgical treatment and results","volume":"12","author":"Kniemeyer","year":"1996"},{"key":"b10-jns101434","series-title":"Stroke","first-page":"1319","article-title":"Recently occluded intracranial and extracranial carotid arteries. 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