Efficacy and safety of different operation methods for symptomatic CICAO surgery

ZHAO Yulong; CHEN Ligang; LIU Jiaming; LIANG Guobiao; YU Chunyong; WANG Xiaogang; LAI Jieyu; GAO Xu

Abstract：Objective To compare the efficacy and safety of different operation methods in the treatment of patients with symptomatic chronic internal carotid artery occlusion(CICAO),so as to provide references for related surgical treatment. Methods A retrospective analysis was made on the clinical data of 101 patients with CICAO who underwent surgical occlusion in the Department of Neurosurgery of the General Hospital of the Northern Theater Command from May 2016 to October 2021. These patients were divided into endovascular treatment group,carotid endarterectomy group and combined operation group. The vascular recanalization,perioperative complications and prognosis of the three groups were compared. Results In the 101 patients,39 were treated with endovascular technique,10 underwent carotid endarterectomy,and the other 52 underwent combined surgery. The success rate was 82.05％ (32/39) vs 90.00％ (9/10) vs 94.23％ (49/52),the incidence of perioperative complications was 10.26％ (4/39) vs 10.00％ (1/10) vs 11.54％ (6/52),and no deaths occurred. The patients were followed 1 month,6 months,and 12 months after the surgery,and the symptoms of the patients were relieved,with just one case of ischemic stroke re-occurrence. Among the 11 patients who failed vascular recanalization,8 showed a certain degree of symptoms worsening and had ipilateral cerebral infarction reoccurrence,and the other 3 were stable and their symptoms improved after long-term antiplatelet therapy. Conclusions Combined surgery for CICAO can improve the technical success rate of vascular recanalization without increasing the incidence of perioperative complications. This method is safe and feasible,and can effectively relieve clinical symptoms and improve prognosis.