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[Related factors of successful endovascular therapy in patients with chronic internal carotid artery occlusion]

G J Zhai1, Y Xu1, X Y Yang1

  • 1Department of Neurology, Suzhou Ninth People's Hospital, Suzhou 215200, China.

Zhonghua Yi Xue Za Zhi
|May 29, 2023
PubMed

Insights

Successful endovascular therapy for chronic internal carotid artery occlusion (ICAO) is more likely with a tapered stump and distal ICA reconstitution. Calcification at the occluded ICA origin is an adverse factor.

Area of Science:

  • Vascular Surgery
  • Interventional Neurology
  • Medical Imaging

Context:

  • Chronic internal carotid artery occlusion (ICAO) presents a significant challenge in stroke prevention.
  • Endovascular therapy offers a treatment option for symptomatic ICAO patients.
  • Identifying factors predictive of successful recanalization is crucial for optimizing treatment outcomes.

Purpose:

  • To retrospectively analyze clinical data of patients with symptomatic chronic ICAO who underwent endovascular therapy.
  • To identify factors associated with successful endovascular recanalization in these patients.
  • To determine predictors of successful endovascular therapy for chronic ICAO.

Summary:

  • A retrospective analysis of 73 symptomatic chronic ICAO patients undergoing endovascular therapy was performed.
  • Distal internal carotid artery (ICA) reconstitution at the clinoid segment (OR=8.946) and a tapered stump (OR=4.488) were significantly associated with successful recanalization.
  • Calcification at the origin of the occluded ICA (OR=0.161) was identified as an adverse factor for successful endovascular therapy.

Impact:

  • Findings highlight the importance of specific anatomical features (tapered stump, distal ICA reconstitution) in predicting successful endovascular treatment for chronic ICAO.
  • Identification of calcification as an adverse factor can aid in pre-procedural risk assessment and patient selection.
  • This study contributes to optimizing endovascular strategies for patients with chronic internal carotid artery occlusion, potentially improving stroke prevention outcomes.

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