Investigation of endovascular recanalization for symptomatic non⁃acute intracranial artery occlusion

Abstract

Objective To explore the feasibility, effectiveness and safety of endovascular recanalization of symptomatic non⁃acute intracranial artery occlusion (SNIATO). Methods Sixty⁃one patients with SNIATO from December 2008 to August 2019 were enrolled. All patients underwent endovascular recanalization. Thrombolysis Cerebral Infarction (TICI) was used to evaluate the recanalization rate and record perioperative complications. For complications during surgery, the prognosis was evaluated by modified Rankin Scale (mRS). The arterial restenosis was observed by DSA. Results Fifty⁃three (86.89%) of 61 patients had successful recanalization, while 8 (13.11%) had failed recanalization. Among the 8 patients, 4 cases failed to pass through the occluded segment with the microwire gave up the operation, one patient died of branch artery bleeding caused by puncture of microwire and was ruptured, and 3 cases died of intracranial hemorrhage (ICH) caused by postoperative cerebral hyperperfusion syndrome (CHS). Fifty⁃three patients with successful recanalization had improved postoperative clinical symptoms and completed 6-24 months for follow⁃up. Forty⁃four patients had a good prognosis, 6 had a moderate prognosis, and 3 had a poor prognosis. Arterial restenosis occurred in 4 patients with no clinical symptoms. Conclusions Endovascular recanalization for SNIATO is technically feasible, and the efficacy is positive. The long⁃term prognosis is good, but the requirements for neurointerventional technology are high. The surgeon must have some technical reserve and clinical experience. During the perioperative period, the doctor must have the ability to manage and treat the complications to cooperate between the treatment team and the nursing team. DOI：10.3969/j.issn.1672⁃6731.2020.06.009

Keywords

• arterial occlusive diseases
• intracranial arterial diseases
• angioplasty
• intraoperativecomplications
• prognosis