Abstract:
:Symptomatic internal carotid artery (ICA) occlusion with hemodynamic impairment remains a dismal disease when untreated. In this prospective, single-center, controlled study, we investigated the feasibility, safety, and long-term outcome of stenting by endovascular recanalization for patients with chronic ICA occlusion. Forty patients with symptomatic chronically occluded ICA were assigned to receive endovascular recanalization (group A, n = 18) or conservative management (group B, n = 22). The primary end point was 100% complete recanalization of the primary occlusion at 60 minutes, and secondary end points were improvement in neurologic function and cognitive function. Patients in the 2 groups were comparable in demographic and baseline characteristics. Successful recanalization was achieved in 88.9% (16 of 18) of patients with the restoration of Thrombolysis in Myocardial Ischemia/Thrombolysis in Cerebral Ischemia 2 or 3 flow. There was no procedural or new cerebral ischemic event. Improvement in brain perfusion was observed in 12 (12 of 18, 75%) patients on single-photon emission computed tomography. Improvement in neurologic function defined as a reduction of ≥4 points on the National Institutes of Health Stroke Scale (NIHSS) at 6 months was observed in group A (baseline, 6.83 ± 3.01 vs 6 months, 2.61 ± 1.20; P < .01) and group B (baseline, 6.05 ± 2.75 vs 6 months, 4.77 ± 1.69; P < .05). A significant difference in NIHSS scores was noted between group A and B at 1, 3, and 6 months (P < .05 or .001). Improvement in cognitive function defined as an increase of ≥8 on the Montreal Cognitive Assessment (MoCA) was observed in group A at 3 and 6 months (baseline, 14.67 ± 3.56 vs 3 months, 24.17 ± 3.55 and 6 months, 24.72 ± 2.85; P < .01). Significant improvement in MoCA was also observed in group B (P < .01). Furthermore, a significant difference in MoCA scores was noted between group A and B at 1, 3, and 6 months (P < .05 or .001). Endovascular recanalization is feasible and safe for patients with symptomatic chronic carotid artery occlusion. Successful carotid artery stenting can improve neurological function and global cognitive function than nonrevascularization.
journal_name
Vasc Endovascular Surgjournal_title
Vascular and endovascular surgeryauthors
Fan YL,Wan JQ,Zhou ZW,Chen L,Wang Y,Yao Q,Jiang JYdoi
10.1177/1538574414525863subject
Has Abstractpub_date
2014-05-01 00:00:00pages
305-10issue
4eissn
1538-5744issn
1938-9116pii
1538574414525863journal_volume
48pub_type
杂志文章abstract::Thoracic endovascular aortic repair has become the preferred modality for the treatment of diverse aortic pathologies of the thoracic aorta. This report is the first to describe the use of 2 different devices for successful exclusion of a dissecting thoracic aneurysm. ...
journal_title:Vascular and endovascular surgery
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journal_title:Vascular and endovascular surgery
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doi:10.1177/1538574419828088
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abstract::Bilateral internal carotid artery agenesis is a very rare congenital anomaly, which may be accompanied by various types of associated vascular abnormalities, included intracranial aneurysms or dolichoectatic change of posterior circulation. In this article, we present unique, and to the best of our knowledge, the firs...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574409347393
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journal_title:Vascular and endovascular surgery
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abstract::Reperfusion injury is the paradoxical and complex phenomenon of exacerbation of cellular dysfunction and increase in cell death after the restoration of blood flow to previously ischemic tissues. It involves biochemical and cellular changes causing oxidant production and complement activation, which culminates in an i...
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journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
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