A retrospective study of the efficacy of endovascular therapy for acute symptoms of internal carotid artery occlusion
- VernacularTitle:血管内治疗症状性急性颈内动脉闭塞疗效的回顾性分析
- Author:
Pinyuan ZHANG
1
;
Jiren ZHANG
;
Dongman ZHAO
;
Shilei QI
;
Guoying DU
;
Jian YANG
Author Information
- Publication Type:Journal Article
- Keywords: acute internal carotid artery occlusion(AICAO); mechanical thrombectomy; cardioembolic stroke; tandem lesion; arterial dissection; endovascular therapy(EVT); internal carotid artery endarterectomy; carotid artery stent implantation surgery
- From: Journal of Xi'an Jiaotong University(Medical Sciences) 2025;46(6):916-924
- CountryChina
- Language:Chinese
- Abstract: Objective To explore the influencing factors of poor prognosis after successful recanalization of symptomatic acute internal carotid artery occlusion(AICAO)by applying endovascular therapy(EVT)technology.Methods We made a retrospective analysis of the clinical and imaging data of 62 symptomatic AICAO patients.After collateral evaluation and recanalization therapy,we obtained flat CT and DSA images,together with the findings of the collateral circulation assessment.At 24.0±6.0 hours after surgery,head plain CT scans were reexamined,and at 14 days after surgery or at discharge,neurological function was assessed using the NIHSS scale.Using the modified Rankin scale,we assessed neurological function and prognosis over a 90-day period.Results Each of the 62 patients had a TICI grade of 2b or 3 and was successfully recanalized.On average,it took 124.36±66.31 minutes from puncture to recanalization.Two instances involved iatrogenic dissection,while twelve cases had intraoperative distal thrombus escape episodes.Of all the patients,32 ones(51.6％)had a fair prognosis,whereas 30 patients(48.4％)had a bad prognosis.The two patient groups differed significantly in the ASPECT score,preoperative NIHSS score,intraoperative balloon catheter usage,postoperative 24 hour and 14 days NIHSS score,postoperative 14 days neurological function,and all-cause mortality within 90 days(all P＜0.05).The best intervention threshold for preoperative NIHSS score was 11.5 points,and both the preoperative NIHSS score and intraoperative BGC utilization were independent predictors influencing poor outcome.Conclusion The preoperative NIHSS score and intraoperative BGC usage are independent predictors of 90-day poor prognosis in AICAO patients with symptomatic AICAO who underwent successful recanalization via endovascular therapy.
