Analysis on application effect of carotid endarterectomy combined with endovascular therapy in patients with Hasan classification type A or B chronic internal carotid artery occlusion

ZHANG Xiaojie; MAIMAITILI Aisha; KAHEERMAN Kadeer; WANG Kai; NIZHAMIDINGJIANG Rexiati; JIANG Shihao; GUO Ke; CHENG Xiaojiang

doi:10.3969/j.issn.1674-3806.2025.08.08

Abstract：Objective To analyze the application effect of carotid endarterectomy(CEA)combined with endovascular therapy in patients with Hasan classification type A or B chronic internal carotid artery occlusion(CICAO).Methods A retrospective analysis was conducted on the clinical data of 34 patients with Hasan classification type A or B CICAO who were admitted to Department of Neurosurgery,the First Teaching Hospital of Xinjiang Medical University from June 2020 to June 2024.All the patients underwent CEA combined with endovascular therapy.The recanalization of the occluded blood vessels,the occurrence of perioperative complications and recovery of neurological function were observed.Results In the 34 patients,the occluded blood vessels were successfully recanalized in 28 patients,with a recanalization rate of 82.35％.The recanalization rate of the patients with Hasan classification type A was 89.47％(17/19),and that of the patients with Hasan classification type B was 73.33％(11/15).There was no statistically significant difference in the recanalization rate between the patients with Hasan classification type A and the patients with Hasan classification type B(P＞0.05).In the 28 patients with successful recanalization of the occluded vessels,perioperative complications occurred in 6 patients,including 3 cases of Hasan classification type A and 3 cases of Hasan classification type B.In the 28 patients with successful recanalization of the occluded vessels,25 patients had good prognosis,including 14 cases of type A and 11 cases of type B,and 3 patients had poor prognosis,all of whom were the patients with Hasan classification type A.There were 2 cases of postoperative vascular restenosis,both of whom were the patients with Hasan classification type A.In 6 patients with failed recanalization of the occluded vessels,there were 2 cases of type A and 4 cases of type B.Conclusion The success rate of CEA combined with endovascular therapy is relatively high in patients with Hasan classification type A or B CICAO,with less perioperative complications,good neurological function recovery and vessel patency after operation.CEA combined with endovascular therapy is a safe and effective treatment method.