Therapeutic effect of combined extracranial-intracranial revascularization in elderly patients with symptomatic chronic internal carotid artery occlusion
10.3760/cma.j.issn.0254-9026.2025.11.012
- VernacularTitle:联合颅内外血运重建术对老年症状性慢性颈内动脉闭塞患者的治疗效果
- Author:
Xiaonan ZHU
1
;
Haitao XU
;
Junhui LIU
;
Rui DING
;
Rongxin GENG
;
Xiang TAO
;
Yuxuan WANG
;
Jing LIU
Author Information
1. 武汉大学人民医院神经外科，武汉 430060
- Publication Type:Journal Article
- Keywords:
Arterial occlusive diseases;
Cerebral revascularization;
Atherosclerosis
- From:
Chinese Journal of Geriatrics
2025;44(11):1549-1555
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the therapeutic effect of combined extracranial-intracranial revascularization on elderly patients with symptomatic chronic internal carotid artery occlusion, and to evaluate its safety and efficacy in the elderly population.Methods:A retrospective analysis was conducted on 35 elderly patients(aged ≥60 years)who underwent combined extracranial-intracranial revascularization for symptomatic chronic internal carotid artery occlusion in the Department of Neurosurgery, Renmin Hospital of Wuhan University from January 2017 to June 2022.The clinical data during hospitalization, as well as the follow-up data within 2 years after operation, were collected and analyzed.Results:A total of 35 cases of combined extracranial-intracranial revascularization were performed on 35 patients.The age at surgery ranged from 60 to 74 years(mean age 65.5 ± 4.2 years). The incidence of reversible neurological deficits within 2 weeks postoperation was 34.3%, and the incidence of focal cerebral infarction within 30 days postoperation was 5.7%.The patency rate of the bridging vessel was 97.1% at 3 months postoperation., and the incidence of focal cerebral infarction during the follow-up period of 30 days to 2 years postoperation was 2.9%.At 3 months after surgery, computed tomography perfusion imaging showed that regional cerebral blood flow(rCBF), regional cerebral blood volume(rCBV), regional mean transit time(rMTT), and regional time to peak(rTTP)were improved compared with those before surgery.The modified Rankin scale score decreased compared to preoperative values, while the Montreal Cognitive Assessment showed improvement in cognitive function compared to preoperative levels(all P<0.05). From 6 months to 1-year postoperation, cerebral angiography showed that 38.7% of the patients had neovascularization of Matsushima grade A or grade B. No cases of cerebral hemorrhage or death was observed during the treatment and follow-up. Conclusions:Combined extracranial-intracranial revascularization is safe and effective for elderly patients with symptomatic chronic internal carotid artery occlusion, which can improve the patient′s hemodynamic disorders, prevent infarction events, and improve the patients′ neurological function and cognitive ability.
