Endovascular recanalization of symptomatic non-acute internal carotid artery occlusion: a new patient classification proposal
10.3760/cma.j.cn115354-20230504-00258
- VernacularTitle:非急性期症状性颈内动脉闭塞患者的血管内再通治疗及患者分类研究
- Author:
Songtao CHEN
1
;
Jinchao XIA
;
Zhaoshuo LI
;
Yongfeng WANG
;
Qiang LI
;
Hao LI
;
Feng LIN
;
Heju LI
;
Tianxiao LI
;
Ziliang WANG
Author Information
1. 河南大学人民医院（河南省人民医院）脑血管介入科，郑州 450003
- Keywords:
Internal carotid artery;
Occlusion;
Endovascular treatment;
Non-acute phase
- From:
Chinese Journal of Neuromedicine
2023;22(8):757-764
- CountryChina
- Language:Chinese
-
Abstract:
Objective:Based on single-center clinical results of endovascular recanalization for symptomatic non-acute internal carotid artery occlusion (ICAO), a new patient classification method is proposed to distinguish the most suitable ICAO patient subgroups for endovascular recanalization.Methods:A total of 140 patients with symptomatic non-acute ICAO accepted endovascular recanalization in Department of Cerebrovascular Intervention, He'nan Provincial People's Hospital from January 2019 to December 2021 were selected. These patients were divided into low risk group ( n=57), medium risk group ( n=54) and high risk group ( n=29) according to the occlusion segments, occlusion times, plaque features, calcification at the occlusion site and occlusion segment angulation. The immediate postoperative recanalization rate, perioperative complications, perioperative death, and prognoses 90 d after endovascular recanalization (modified Rankin scale scores of 0-2 as good prognosis) were evaluated in the 3 groups. Results:The immediate postoperative recanalization rate was 82.9% (114/140), perioperative complication rate was 11.4% (16/140), and perioperative mortality was 0.7% (1/140). The success recanalization rate decreased gradually from the low risk group to the high risk group (100%, 85.2%, and 37.9%), while the perioperative complication rate was the opposite (0%, 11.1%, and 34.5%), with significant differences ( P<0.05). Ninety d after endovascular recanalization, 109 patients had good prognosis and 27 had poor prognosis; the good prognosis rate in low risk group, medium risk group and high risk group was 98.2%, 79.6% and 34.5%, respectively, with significant differences ( P<0.05). The vascular restenosis rate in low risk group, medium risk group and high risk group was 0%, 8.7% and 18.2%, and re-occlusion rate was 0%, 6.5% and 27.2%, respectively, 90 d after endovascular recanalization, with significant differences ( P<0.05). Conclusion:Endovascular recanalization is technically feasible for patients with symptomatic non-acute ICAO, especially those met the criterions of low and medium risk groups in our study.
