Efficacy of revascularization therapy for chronic internal carotid artery occlusion with intracranial hypoperfusion
ZHANG Xiao-jie
MAIMAITILI Aisha
KAHEERMAN Kadeer
JIANG Shi-hao
GUO Ke
WANG Kai
NIZHAMIDINGJIANG Rexiati
CHENG Xiao-jiang
Abstract：Objective To investigate the clinical efficacy of revascularization therapy for chronic internal carotid artery occlusion with intracranial hypoperfusion.Methods The clinical data of 72 patients with chronic internal carotid artery occlusion with intracranial hypoperfusion who underwent vascular recanalization therapy between June 2020 and June 2024 were retrospectively analyzed.Results According to the Hasan classification,there were 37 cases of type A,22 of type B,11 of type C,and 2 of type D.Among them,13 patients were treated with carotid endarterectomy(CEA group),19 with carotid artery stenting(CAS group),and 40 with hybrid surgery(hybrid group).Immediate postoperative angiography showed successful vascular recanalization in 53 cases,yielding an overall recanalization rate of 73.61%.The recanalization rates were 76.92%(10/13)in the CEA group,68.42%(13/19)in the CAS group,and 75.00%(30/40)in the hybrid group,with no statistically significant difference among the three groups(P=0.828).The recanalization rates for Hasan type A,B,C,and D were 83.78%(31/37),72.72%(16/22),54.55%(6/11),and 0%,respectively.The recanalization rate in patients with Hasan types A and B(79.66%)was significantly higher than that in those with types C and D(46.15%;P=0.033).The incidence of postoperative complications in the CEA group[7.69%(1/13)]was lower than that in the CAS group[31.58%(6/19)]and the hybrid group[22.50%(9/40)],but no statistically significant difference was observed among the three groups(P=0.320).A 6-month postoperative follow-up was conducted for the 53 patients with successful recanalization,including 10 in the CEA group,13 in the CAS group,and 30 in the hybrid group.The incidence of postoperative restenosis was 0%in the CEA group,7.69%(1/13)in the CAS group,and 6.67%(2/30)in the hybrid group,with no statistically significant difference among the groups(P>0.999).The rates of favorable prognosis(mRS score≤2)were 90.00%(9/10)in the CEA group,92.31%(12/13)in the CAS group,and 86.67%(26/30)in the hybrid group,with no statistically significant difference(P>0.999).Conclusion Vascular recanalization therapy is a safe and effective treatment for patients with chronic internal carotid artery occlusion with intracranial hypoperfusion,with satisfactory short-term follow-up outcomes,particularly in patients with Hasan types A and B.CEA,CAS,and hybrid surgery can all achieve good outcomes,and the recanalization method should be chosen according to the specific condition of the patient.
Keywords：Chronic internal carotid artery occlusionIntracranial hypoperfusionCarotid endarterectomyCarotid artery stentingHybrid surgeryClinical efficacy
Publication Date：2025-08-25
Online Publishing Date：2025-10-21(First online date of this platform, not the publication date of the document)
Pages：8( 449-456 )