Interventional Radiology
Endovascular recanalization for non-acute internal carotid artery occlusion using a new angiographic classification
Sun Xuan, Ma Ning, Mo Dapeng, Song Ligang, Liu Lian, Huo Xiaochuan, Deng Yiming, Xu Xiaotong, Miao Zhongrong, Gao Feng
Published 2021-05-10
Cite as Chin J Radiol, 2021, 55(5): 478-483. DOI: 10.3760/cma.j.cn112149-20200514-00687
Abstract
ObjectiveTo evaluate the safety and feasibility of endovascular recanalization for non-acute internal carotid artery occlusion (NA-ICAO), and to propose a new angiographic classification.
MethodsFrom April 2015 to October 2019, 95 consecutive patients with symptomatic NA-ICAO who received endovascular recanalization were retrospectively analyzed in Beijing Tiantan Hospital, Capital Medical University. All the patients were divided into four groups according to DSA: type Ⅰ, petrous segments were distally reconstituted by collateral vessels; type Ⅱ, cavernous segments were distally reconstituted by collateral vessels; type Ⅲ, ophthalmic segments were distally reconstituted by collateral vessels; type Ⅳ, communicating segments were distally reconstituted by collateral vessels. Study data including clinical characteristics, surgical details, lesion classification, recanalization rate and perioperative complications. For the counting data, the χ2 test was used to compare between groups. For the quantitative data, the ANOVA was used for the normal distribution data, otherwise the Kruskal-Wallis H test was used. The primary safety outcome was any stroke or death within 30 days.
ResultsAmong the 95 patients, 67 (70.53%) had successful recanalization. The recanalization rates of type Ⅰ－Ⅳ were 92.31% (36/39), 81.82% (18/22), 47.83% (11/23) and 18.18% (2/11) respectively (χ²=29.557, P<0.001). And the complication rates of the four types were 5.13% (2/39), 13.64% (3/22), 21.74% (5/23) and 9.10% (1/11) respectively. The incidence of perioperative ischemic stroke was 2.11% (2/95). No other serious stroke and death occurred.
ConclusionsEndovascular recanalization may be feasible and safe for carefully selected patients with NA-ICAO and therefore represents an alternative treatment. The patients with type Ⅰ and Ⅱ lesions had higher recanalization rates, while the patients with type Ⅳ lesions had significantly lower recalculation rate. The new angiographic classification is conducive to the selection of suitable patients and difficulty in grading.
Key words:
Carotid artery, internal; Occlusion; Endovascular treatment; Classification
Contributor Information
Sun Xuan
Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Ma Ning
Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Mo Dapeng
Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Song Ligang
Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Liu Lian
Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Huo Xiaochuan
Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Deng Yiming
Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Xu Xiaotong
Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Miao Zhongrong
Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Gao Feng
Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
