Effects and safety of endovascular recanalization for non-acute symptomatic intracranial vertebral artery occlusion with different risks

Shunqiang Chen ¹, Jinchao Xia ², Shuxin Xiao ²

⁰Henan Provincial Intervention Center, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, China.

Medicine +

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February 16, 2024

View abstract on PubMed

Summary

Endovascular recanalization is feasible for non-acute symptomatic intracranial vertebral artery occlusion. Low- and medium-risk patients benefit from this procedure, showing good clinical outcomes.

Area Of Science

Neurology
Vascular Surgery
Interventional Radiology

Background

Optimal treatment for non-acute symptomatic intracranial vertebral artery occlusion remains unclear.
Endovascular recanalization is a complex procedure with variable outcomes.

Purpose Of The Study

To assess the feasibility and safety of endovascular recanalization for non-acute symptomatic intracranial vertebral artery occlusion.
To identify patient subgroups who may benefit most from this intervention.

Main Methods

Retrospective analysis of 92 patients undergoing endovascular recanalization for non-acute symptomatic intracranial vertebral artery occlusion (Jan 2019-Dec 2021).
Patients were classified into risk groups based on imaging findings, occlusion characteristics (length, duration, nature, calcification, angulation).
Outcomes assessed included recanalization success, perioperative complications, and 90-day functional outcomes (modified Rankin Scale).

Main Results

Overall recanalization success rate was 83.7% with a 10.9% perioperative complication rate.
Recanalization success decreased significantly in higher-risk groups (100% low-risk, 93.3% medium-risk, 27.8% high-risk).
Perioperative complications and 90-day poor functional outcomes (mRS 3-6) increased with risk stratification (0% low-risk, 10% medium-risk, 38.9% high-risk).

Conclusions

Endovascular recanalization is a safe and feasible option for carefully selected low- and medium-risk patients with non-acute symptomatic intracranial vertebral artery occlusion.
The procedure offers a potential alternative to conservative management for suitable candidates.
Risk stratification is crucial for predicting outcomes and guiding patient selection for endovascular intervention.