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Interventional Treatment for Internal Carotid Artery Near-Occlusion with Different Distal Vessel Diameters
Bowen Zheng1, Shijun Zhang1, Guanhao Ke1
1Department of Neurology, The Fourth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Insights
Endovascular treatment is safe and effective for internal carotid artery near-occlusion, regardless of distal vessel diameter. This minimally invasive approach shows comparable outcomes in patients with smaller or larger distal vessels.
Area of Science:
- Vascular Surgery
- Interventional Neurology
- Endovascular Therapy
Background:
- Internal carotid artery near-occlusion presents treatment challenges.
- Distal vessel diameter is a key factor in endovascular procedure planning.
Purpose of the Study:
- To evaluate the safety and efficacy of endovascular treatment for internal carotid artery near-occlusion.
- To compare outcomes in patients with distal vessel diameters ≤2 mm versus >2 mm.
Main Methods:
- Retrospective study of 66 patients undergoing endovascular treatment for internal carotid artery near-occlusion.
- Patients divided into full collapse (≤2 mm) and non-full collapse (>2 mm) groups.
- Dual antiplatelet therapy and procedural protection (umbrella or stent) were utilized.
Main Results:
- 100% technical success rate for endovascular treatment in both groups.
- Comparable perioperative adverse event rates (21.43% vs. 21.05%).
- No significant difference in 12-month ipsilateral stroke incidence or restenosis.
Conclusions:
- Endovascular treatment is safe and effective for internal carotid artery near-occlusion across different distal vessel diameters.
- The procedure demonstrates consistent success and safety profiles irrespective of distal vessel size.
Objective:
To investigate the efficacy and safety of endovascular treatment in patients with internal carotid artery near-occlusion accompanied by a distal vessel diameter of ≤2 mm.
Methods:
Sixty-six patients who underwent endovascular treatment for internal carotid artery near-occlusion at the Fourth Affiliated Hospital of Guangzhou Medical University and Guangdong Provincial Hospital of Traditional Chinese Medicine between February 2018 and November 2023 were divided into a full collapse group (distal vessel diameter ≤2 mm, n = 28) and a nonfull collapse group (distal vessel diameter >2 mm, n = 38). All patients received dual antiplatelet therapy before the procedure. Protection with a protective umbrella or thrombectomy stent was used during surgery according to the lesion characteristics.
Results:
Baseline characteristics were comparable between the 2 groups. The endovascular treatment success rate was 100% in both groups. There was no significant between-group difference regarding the use of small balloon predilation. The incidence of perioperative adverse events (such as ipsilateral stroke, hyperperfusion, hypotension, and myocardial infarction) was comparable in the 2 groups (21.43% and 21.05%, respectively; P > 0.05). At the 12-month follow-up, the full collapse group had a higher incidence of ipsilateral stroke (7.14% vs. 2.63%), but the difference was not statistically significant. There was 1 case of restenosis in both groups.
Conclusions:
Our findings demonstrate the safety and effectiveness of endovascular treatment for patients with internal carotid artery near-occlusion with different distal vessel diameters.
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