Preliminary experience of endovascular revascularization for chronic long segment internal carotid artery occlusion
10.3760/cma.j.issn.1005-1201.2018.06.010
- VernacularTitle:慢性长节段颈内动脉闭塞血管内开通术初步研究结果
- Author:
Dongyang CAI
1
;
Tongyuan ZHAO
;
Tianxiao LI
;
Jiangyu XUE
;
Kun ZHANG
;
Jinchao XIA
;
Bowen YANG
;
Yingkun HE
Author Information
1. 450003,郑州大学人民医院(河南省人民医院)复合手术神经外科
- Keywords:
Internal carotid artery;
Aterial occlusive diseases;
Endovascular treatment;
Recanalization
- From:
Chinese Journal of Radiology
2018;52(6):457-462
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the feasibility,safety and effect of endovascular revascularization for chronic long segment internal carotid artery occlusion. Methods The cases of chronic long segment internal carotid artery occlusion who were treated by endovascular revascularization in our center from May 2015 to April 2017 were reviewed. Eleven cases met the inclusion criteria:the duration of the occlusion was more than three weeks and the segment of the occlusion was beyond the petrosal segment of internal carotid arteries from the initial segment. All of the cases had the related symptoms and had declining cerebral perfusion. The analysis index included:baseline information,radiological information,perioperative results, clinical follow-up and imaging follow-up. The imaging follow-up index were the re-stenosis or re-occlusion of the revascularized artery. Results The occlusion was recanalized successfully in 9 of 11 patients,the two procedures were abandoned after repeated attempts and the guide wire could not reach the true lumen when navigating in the cavernous segment. Six cases of the nine successfully recanalized cases accepted perfusion-weighted imaging scan. Cerebral perfusion of all the cases were improved. Thrombus shifting was observed in one case and occluded a subbranch,mechanical thrombectomy was performed successfully,the case was recovered well without sequela. No symptomatic stroke or death was happened in the perioperative period. All of the nine cases who successfully recanalized acquired clinical follow-up,median follow-up time was ten months(4—28 months). No ischemic stroke and death happened after the procedures. Seven of nine cases improved in the clinical symptoms. Five cases accepted the imaging follow-up. The meantime was six months. No re-occlusion was happened. Conclusions Endovascular revascularization for chronic long segment internal carotid artery occlusion is feasible,safe,and short-term effective. More clinical research is needed to verify the long-term effect.
