Endovascular Management of Long-Segmental Petrocavernous Internal Carotid Artery (Carotid S) Occlusion.
10.5853/jos.2015.17.3.336
- Author:
Soonchan PARK
1
;
Eun Suk PARK
;
Jae Hyuk KWAK
;
Dong Geun LEE
;
Dae Chul SUH
;
Sun U KWON
;
Deok Hee LEE
Author Information
1. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. dhlee@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Stroke;
Carotid artery, internal;
Atherosclerosis;
Angioplasty, balloon;
Stents
- MeSH:
Angioplasty, Balloon;
Atherosclerosis;
Carotid Artery, Internal*;
Constriction, Pathologic;
Follow-Up Studies;
Humans;
Infarction;
Ischemic Attack, Transient;
Phenobarbital;
Stents;
Stroke
- From:Journal of Stroke
2015;17(3):336-343
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND PURPOSE: Long-segmental thrombotic occlusion of the distal internal carotid artery (ICA) sparing the cervical segment proximally and the supraclinoid segment distally, which could be termed 'Carotid S occlusion', has an unusual clinical presentation. However, endovascular management of this lesion is challenging. The purpose of our study is to report our endovascular treatment clinical experience of the disease. METHODS: From March 2008 to June 2013, we could identify 14 patients (average age: 62.1, median age: 62, range: 50-79) with \'Carotid S occlusion', who underwent endovascular recanalization procedures. Patient's clinical presentations were collected and the imaging findings also analyzed. The technical success rate, 24-hour and follow-up imaging outcome, and the clinical outcome using the 90-day mRS (modified Rankin scale) score were evaluated. RESULTS: Patients presented with gradually progressing (n = 8), fluctuating (n = 3), transient ischemic attack (n = 2) and stationary (n = 1) symptoms. DWI showed internal and external border-zone lesions in six patients, only internal ICA border-zone lesions in three patients, and only external border-zone lesions in two patients. Underlying distal ICA stenosis was noted in 12 patients. The technical success rate was 92.8% (13/14). Luminal patency was noted in all patients (100%) after 24 hours and in nine of 10 (90%) on long-term follow-up (median: 6.5, average: 15.1, range: 1-39 months). A 90-day, good functional outcome (mRS < or = 2) was noted in 13 of 14 patients (92.8%). CONCLUSIONS: \'Carotid S occlusion' usually presented with border-zone infarction and endovascular management of the lesions was feasible. A relatively successful clinical outcome could be achieved after successful revascularization.
