Interventional Radiology
Endovascular recanalization of the symptomatic non-acute occlusion of large intracranial artery of circulation: preliminary study
Huaqiao Tan, Yongliang Wang, Lin Ma, Hao Feng, Yuanhua Liu, Chun Fang, Jichong Xu, Shuo Yan, Hongjie Han
Published 2019-01-10
Cite as Chin J Radiol, 2019, 53(1): 50-56. DOI: 10.3760/cma.j.issn.1005-1201.2019.01.011
Abstract
ObjectiveTo investigate the feasibility, safety and efficacy of endovascular recanalization of the symptomatic occlusion of large intracranial artery in anterior circulation.
MethodsFrom October 2015 to December 2017, 13 patients with symptomatic non-acute occlusion of large intracranial artery in anterior circulation were enrolled into this study and underwent endovascular recanalization. The initial procedural results, including the rate of successful recanalization and perioprocedural complications, and angiographic and clinical follow-up results were collected. The functional outcome was evaluated at discharge and 90 days.
ResultsRecanalization was successful in 11 out of 13 patients. Perioperative complications occurred in 8 cases, including distal embolization in 7 cases (3 with symptom and 4 without), in which intracerebral hemorrhage associated with embolectomy was found in 1 case; and distal embolization concomitant with artery dissection in 1 case. At discharge, the symptoms of 10 out of 11 patients with successful recanalization were improved and 1 was unchanged; one of 2 patients with recanalization failure was aggravated and 1 was unchanged. After the procedure, 1 patient with successful recanalization, but complicated with intracerebral hemorrhage associated with embolectomy was lost at follow-up, thus angiographic follow-up was available in the remaining 10 patients. Of the 10 patients, 1 patient developed in-stent restenosis at 12 months and 9 patients had no hemodynamic stenosis/reocclusion. The clinical follow-up was available in 12 patients. No recurrence of TIA or stroke was found in 9 cases with successful recanalization except for 1 case who developed in-stent stenosis and suffered from TIA. At the follow-up of 90 days, 10 patients with successful recanalization showed good function (mRS: 0-2), 2 patients with recanalization failure were deteriorated.
ConclusionsIn strictly selected patients with symptomatic non-acute occlusion of large intracranial artery in anterior circulation, endovascular recanalization was feasible and safe, which may improve patients' symptoms in a short term and reduce the recurrence rate of stroke, but its definite efficacy needs to be confirmed by studies with larger sample and longer follow-up.
Key words:
Intracranial arterial diseases; Arterial occlusive diseases; Radiology, interventional; Endovascular recanalization, non-acute
Contributor Information
Huaqiao Tan
Department of Interventional Radiology, Tongji Hospital Affiliated of Tongji University, Shanghai 200065, China
Yongliang Wang
Department of Interventional Radiology, the Fourth Division Hospital of Xinjiang Production and Construction Corps, Yining 835000, China
Lin Ma
Department of Interventional Radiology, Tongji Hospital Affiliated of Tongji University, Shanghai 200065, China
Hao Feng
Department of Interventional Radiology, Tongji Hospital Affiliated of Tongji University, Shanghai 200065, China
Yuanhua Liu
Department of Neurology, Tongji Hospital Affiliated of Tongji University, Shanghai 200065, China
Chun Fang
Department of Interventional Radiology, Tongji Hospital Affiliated of Tongji University, Shanghai 200065, China
Jichong Xu
Department of Interventional Radiology, Tongji Hospital Affiliated of Tongji University, Shanghai 200065, China
Shuo Yan
Department of Interventional Radiology, Tongji Hospital Affiliated of Tongji University, Shanghai 200065, China
Hongjie Han
Department of Interventional Radiology, Tongji Hospital Affiliated of Tongji University, Shanghai 200065, China
