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Recanalization of chronic long-segment occlusion of the internal carotid artery with endovascular and hybrid surgery

To investigate the effect of endovascular and/or hybrid surgical recanalization on chronic long-segment occlusion of the internal carotid artery (ICA) and the effect of occlusion location on the recanalization rate and prognosis, 87 patients with chronic ICA occlusion treated with endovascular appro...

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Autores principales: Ren, Wei, Xue, Jiangyu, Zhao, Tongyuan, Xu, Gangqin, Yang, Bowen, Li, Tianxiao, Gao, Bulang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10562445/
https://www.ncbi.nlm.nih.gov/pubmed/37813974
http://dx.doi.org/10.1038/s41598-023-44406-x
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author Ren, Wei
Xue, Jiangyu
Zhao, Tongyuan
Xu, Gangqin
Yang, Bowen
Li, Tianxiao
Gao, Bulang
author_facet Ren, Wei
Xue, Jiangyu
Zhao, Tongyuan
Xu, Gangqin
Yang, Bowen
Li, Tianxiao
Gao, Bulang
author_sort Ren, Wei
collection PubMed
description To investigate the effect of endovascular and/or hybrid surgical recanalization on chronic long-segment occlusion of the internal carotid artery (ICA) and the effect of occlusion location on the recanalization rate and prognosis, 87 patients with chronic ICA occlusion treated with endovascular approach only or hybrid surgery were retrospectively enrolled. The duration of ICA occlusion ranged from 21 to 360 days (median 30). Type I occlusion (from the neck to below the cavernous segment) consisted of 46 (52.8%) patients while type II (from the neck to above the clinoid segment) of 41 (47.1%). Hybrid surgery was performed in 44 (50.6%) patients while endovascular recanalization only was conducted in the other 43 (49.4%). In all patients, the success rate of recanalization was 93.0% (40/43) for the endovascular approach and 95.5% for the hybrid surgical approach. In patients with type I occlusion, endovascular recanalization only was performed in 22 (47.8%) patients and hybrid surgery in 24 (52.2%), resulting in successful recanalization in all patients (100%). In patients with type II occlusion, the success rate of recanalization was 85.7% (18/21) for the endovascular approach only but 90% (18/20) for the hybrid surgery. The total success rate of recanalization was 94.3% (82/87) for all patients, 100% for type I occlusion, and 87.8% for type II occlusion. No significant (P = 0.12) differences existed in the recanalization rate between groups I and II. Clinical follow-up was performed in 82 (94.3%) patients 6–39 months (mean 16) after the surgery. Re-occlusion occurred in 0 in group I but in four (9.8%) in group II. The mRS was good with 0–2 in 38 (82.6%) patients in group I and in 27 (75%) patients in group II, with no significant (P = 0.78) difference. In conclusion, chronic long-segment ICA occlusion can be safely and efficiently recanalized with the endovascular and hybrid surgery. The location of ICA occlusion may have a critical role in determining the recanalization rate, and careful evaluation of the occlusion location may be helpful in increasing the prognosis of recanalization.
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spelling pubmed-105624452023-10-11 Recanalization of chronic long-segment occlusion of the internal carotid artery with endovascular and hybrid surgery Ren, Wei Xue, Jiangyu Zhao, Tongyuan Xu, Gangqin Yang, Bowen Li, Tianxiao Gao, Bulang Sci Rep Article To investigate the effect of endovascular and/or hybrid surgical recanalization on chronic long-segment occlusion of the internal carotid artery (ICA) and the effect of occlusion location on the recanalization rate and prognosis, 87 patients with chronic ICA occlusion treated with endovascular approach only or hybrid surgery were retrospectively enrolled. The duration of ICA occlusion ranged from 21 to 360 days (median 30). Type I occlusion (from the neck to below the cavernous segment) consisted of 46 (52.8%) patients while type II (from the neck to above the clinoid segment) of 41 (47.1%). Hybrid surgery was performed in 44 (50.6%) patients while endovascular recanalization only was conducted in the other 43 (49.4%). In all patients, the success rate of recanalization was 93.0% (40/43) for the endovascular approach and 95.5% for the hybrid surgical approach. In patients with type I occlusion, endovascular recanalization only was performed in 22 (47.8%) patients and hybrid surgery in 24 (52.2%), resulting in successful recanalization in all patients (100%). In patients with type II occlusion, the success rate of recanalization was 85.7% (18/21) for the endovascular approach only but 90% (18/20) for the hybrid surgery. The total success rate of recanalization was 94.3% (82/87) for all patients, 100% for type I occlusion, and 87.8% for type II occlusion. No significant (P = 0.12) differences existed in the recanalization rate between groups I and II. Clinical follow-up was performed in 82 (94.3%) patients 6–39 months (mean 16) after the surgery. Re-occlusion occurred in 0 in group I but in four (9.8%) in group II. The mRS was good with 0–2 in 38 (82.6%) patients in group I and in 27 (75%) patients in group II, with no significant (P = 0.78) difference. In conclusion, chronic long-segment ICA occlusion can be safely and efficiently recanalized with the endovascular and hybrid surgery. The location of ICA occlusion may have a critical role in determining the recanalization rate, and careful evaluation of the occlusion location may be helpful in increasing the prognosis of recanalization. Nature Publishing Group UK 2023-10-09 /pmc/articles/PMC10562445/ /pubmed/37813974 http://dx.doi.org/10.1038/s41598-023-44406-x Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Ren, Wei
Xue, Jiangyu
Zhao, Tongyuan
Xu, Gangqin
Yang, Bowen
Li, Tianxiao
Gao, Bulang
Recanalization of chronic long-segment occlusion of the internal carotid artery with endovascular and hybrid surgery
title Recanalization of chronic long-segment occlusion of the internal carotid artery with endovascular and hybrid surgery
title_full Recanalization of chronic long-segment occlusion of the internal carotid artery with endovascular and hybrid surgery
title_fullStr Recanalization of chronic long-segment occlusion of the internal carotid artery with endovascular and hybrid surgery
title_full_unstemmed Recanalization of chronic long-segment occlusion of the internal carotid artery with endovascular and hybrid surgery
title_short Recanalization of chronic long-segment occlusion of the internal carotid artery with endovascular and hybrid surgery
title_sort recanalization of chronic long-segment occlusion of the internal carotid artery with endovascular and hybrid surgery
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10562445/
https://www.ncbi.nlm.nih.gov/pubmed/37813974
http://dx.doi.org/10.1038/s41598-023-44406-x
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