Estimation and Recanalization of Chronic Occluded Internal Carotid Artery: Hybrid Operation by Carotid Endarterectomy and Endovascular Angioplasty

World Neurosurgery
Bing LiuJianning Zhang

Abstract

Proper treatment for chronic occluded internal carotid artery (ICA) has not been determined. Endovascular recanalization may cause arterial injury and distal embolism. Hybrid recanalization for chronic occluded ICA was performed, and its safety and effectiveness were estimated. From March 2011 to March 2017, 21 patients were treated by hybrid recanalization with >1 year of follow-up. The ICA was totally occluded from the cervical segment to the cavernous, ophthalmic, or supraclinoid segment. Clinical characteristics, treatment strategy, recanalization rate, and main adverse events were reviewed retrospectively. Initial recanalization was achieved in 15 patients (71.4%). Successful revascularization was more likely if the ICA was occluded with the plaque at the carotid bifurcation and the thrombus anterograde to the cavernous segment. There was no carotid dissection or intracranial hemorrhage. There were no new postprocedural neurologic deficits. Among 14 patients who underwent successful recanalization with follow-up, 1 patient had a repeat occlusion and another experienced about 50% restenosis. Hybrid recanalization by carotid endarterectomy and arterial angioplasty is a safe treatment method for chronic totally occluded ICA. ...Continue Reading

Citations

Jun 19, 2021·Clinical Neurology and Neurosurgery·Weijian FanYizhi Liu

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