Endovascular recanalization for chronic carotid artery occlusion

Abstract

Objective To summarize the experiences and perioperative complications of endovascular recanalization in chronic carotid artery occlusion (CCAO). Methods A total of 12 patients with CCAO were included from August 2018 to July 2019, who were all treated with endovascular recanalization. The occlusive site, occlusive segment, occlusive proximal stump morphology and the nature of the lesion were evaluated by multimode imaging, and perioperative complications were recorded. Results Ten patients were successfully operated, the success rate of endovascular recanalization was 10/ 12. Two patients had failed in surgery, including one patient with long segment artery dissection above the petrous bone segment and one patient with blunt stump. Perioperative complications occurred in 6 patients, including 3 cases of intraoperative embolus shedding, one case of intraoperative vasospasm, one case of postoperative cerebral hyperperfusion syndrome (CHS), and one case of postoperative severe hypotension. Conclusions The long segment lesion above the petrous bone segment, the shape of the stump and the nature of lesion may affect the success rate of endovascular recanalization. Embolus detachment, vasospasm, CHS and hypotension are the main perioperative complications. DOI：10.3969/j.issn.1672⁃6731.2020.06.007

Keywords

• arterial occlusive diseases
• carotid artery dieseases
• angioplasty
• saccule and utricle
• stents
• intraoperativecomplications