Endovascular Treatment for Symptomatic Non-acute Long-segment Internal Carotid Artery Occlusion: Outcomes of Two Recanalization Techniques

作者：Chun Zhou, Zhen-Yu Jia, Yuezhou Cao, Linbo Zhao, Shan-Shan Lu, Xiao‐Quan Xu, Hai-Bin Shi, Sheng Liu · 发表于：American Journal of Neuroradiology · 年份：2026 · DOI：10.3174/ajnr.a9281 · 研究领域：Cerebrovascular and Carotid Artery Diseases、Acute Ischemic Stroke Management、Intracranial Aneurysms: Treatment and Complications

BACKGROUND AND PURPOSE: For symptomatic non-acute long-segment internal carotid artery occlusion (LICAO) lesions, the endovascular treatment strategies are always complex and challenging. This study aims to analyze the effect of two recanalization techniques (angioplasty without distal embolic protection (AWDEP) or direct Aspiration Recanalization combined with angioplaSty under Intracranial Stent retriever protection (ARSIS) technique) on the technical success rate and clinical prognosis. MATERIALS AND METHODS: Fifty-three LICAO patients who underwent endovascular treatment at our center were retrospectively analyzed, including 41 (77.4%) patients in the AWDEP group and 12 (22.6%) in the ARSIS group. Patients’ clinical information, radiologic characteristics, recanalization rates, perioperative complications, and follow-up outcomes were compared between the two groups. RESULTS: Among these patients, the median interval from radiologic occlusion to recanalization was 35 days. Successful recanalization was achieved in lower proportion of the AWDEP group than that of the ARSIS group (82.9% versus 100%, P = 0.29). The total number and length of implanted stents in the AWDEP group were significantly more than that in the ARSIS group ( P = 0.009 and P = 0.007, respectively). The incidence of periprocedural complications and in-stent restenosis among patients with AWDEP technique were numerically higher than that with ARSIS technique (19.5% versus 0%, P = 0.23 and 26.5%...