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Endovascular Revascularization of Multi Segment Chronically Occluded ICA
Nicholas Mulchan1, Phillip Yeun2, Jennifer Frontera1
1Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA.
Summary
A novel endovascular technique successfully treated chronic internal carotid artery (ICA) occlusion using multiple stents. This approach reconstructed the ICA, leading to significant symptom improvement and penumbra recovery in a stroke patient.
Area of Science:
- Vascular Surgery
- Interventional Neurology
- Endovascular Therapy
Background:
- Chronic internal carotid artery (ICA) occlusion presents a significant challenge in stroke management.
- Traditional treatment options for ICA occlusion are limited, especially for extensive intracranial occlusions.
Observation:
- A 55-year-old male with bilateral ICA occlusion experienced persistent stroke symptoms despite medical management.
- Advanced imaging revealed bilateral ICA occlusions with significant hypoperfusion and neurological deficits.
Findings:
- A novel endovascular approach successfully reconstructed the left ICA using seven consecutive coronary-carotid stents from the ophthalmic to the cervical segment.
- Post-procedure, the patient exhibited marked symptom improvement, with imaging confirming penumbra recovery and infarct stability.
Implications:
- This case demonstrates the feasibility and efficacy of a multi-stent technique for complex ICA reconstructions.
- This approach offers a potential new treatment strategy for select patients with chronic ICA occlusions and associated stroke symptoms.
