Endovascular Recanalization of Symptomatic Chronic ICA Occlusion: Procedural Outcomes and Radiologic Predictors

作者：Chun Zhou, Yuezhou Cao, Zhenyu Jia, Lin‐Bo Zhao, Shan-Shan Lu, Hai‐Bin Shi, Sheng Liu · 发表于：American Journal of Neuroradiology · 年份：2023 · DOI：10.3174/ajnr.a7804 · 被引用次数：14 · 研究领域：Acute Ischemic Stroke Management、Cardiac pacing and defibrillation studies、Peripheral Artery Disease Management

BACKGROUND AND PURPOSE: Endovascular recanalization has been attempted in patients with symptomatic chronic ICA occlusion, however, the heterogeneity of recanalization outcomes and the perioperative complications present challenges for the clinical application. Our aim was to evaluate the safety and efficacy of endovascular recanalization for symptomatic chronic ICA occlusion and identify potential predictors for successful recanalization. MATERIALS AND METHODS: This study included 47 consecutive patients with symptomatic chronic ICA occlusion who underwent endovascular recanalization at our institution. Patients’ clinical information, radiologic characteristics, procedural results, and outcomes were recorded. Factors related to technical success were analyzed by univariate and multivariate analyses. RESULTS: The technical success rate was 74.5% (35/47); 12.8% of patients (6/47) experienced intraoperative complications, but none had permanent neurologic deficits. Three months after recanalization, 21 of the 29 recanalized patients (72.4%) and 3 of the 10 failed patients (30.0%) demonstrated improved mRS scores. Restenosis or re-occlusion occurred in 12.9% of patients (4/31) with successful recanalization. Multivariate analysis showed that tapered or blunt stump ( P = .016), distal ICA occlusion segment (below the cavernous segment versus at or above the ophthalmic segment, P = .003; at the cavernous or clinoid segment versus at or above the ophthalmic segment, P ...