Hybrid surgery for chronic symptomatic occlusion of the internal carotid artery: an analysis of 9 cases
10.3760/cma.j.issn.1671-8925.2019.11.003
- VernacularTitle:复合手术治疗慢性症状性颈内动脉闭塞的初步探索(附九例报道)
- Author:
Jiheng HAO
1
;
Meng ZHANG
;
Chao LIU
;
Zidong WANG
;
Weidong LIU
;
Kai LIN
;
Jiyue WANG
;
Liyong ZHANG
Author Information
1. 聊城市脑科医院神经外科 252000
- Keywords:
Internal carotid artery occlusion;
Hybrid surgery;
Endarterectomy;
Fogarty catheter embolectomy;
Carotid artery stenting
- From:
Chinese Journal of Neuromedicine
2019;18(11):1091-1097
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the feasibility and safety of hybrid surgery in treatment of chronic symptomatic internal carotid artery occlusion.MethodsFrom April 2016 to December 2018, 9 patients with chronic symptomatic internal carotid artery occlusion confirmed by digital subtraction angiography were treated with carotid endarterectomy (CEA)+double chamber Fogarty balloon (3F) embolectomy or stent implantation when necessary. The clinical data of these patients were retrospectively analyzed. Vascular recanalization and complications during perioperative period and follow-up of the patients were analyzed.ResultsCEA+double chamber Fogarty balloon (3F) thrombectomy was performed in 5 patients; and stent placement was performed in 4 patients after Fogarty balloon thrombectomy. The internal carotid arteries of all 9 patients were unobstructed immediately during the operation. Postoperative hyperperfusion syndrome occurred in 3 patients; blood pressure was strictly controlled and the symptoms gradually relieved after proper dehydration. No serious complications such as cerebral hemorrhage, cerebral infarction, or nerve injury occurred. The duration of follow-up was 4-36 months; no patient developed a new stroke or death; no re-occlusion appeared; but one mild restenosis (50％) was detected. one patient suffered from a TIA attack 6 months after operation. ConclusionHybrid surgery is an effective method for treatment of chronic symptomatic internal carotid artery occlusion; however, preoperative evaluation and selection of patients should be carefully; individualized treatment plans should be developed.
