Endovascular Treatment for Near Occlusion of the Internal Carotid Artery

摘要

Background The treatment strategy and the correct incidence of near occlusion (NO) of the internal carotid artery (ICA) is still controversial. In routine radiological imaging NO can easily be misdiagnosed as complete occlusion and there is no consensus on the standard treatment strategy. Purpose To present our perioperative and long-term follow-up results of ICA NO patients treated with carotid artery stenting (CAS). Material and Methods Between 2004–2014 a total of 182?patients with ICA NO were evaluated for CAS. The study included 132?male (72.5?%) and 50?female (27.5?%) patients with a?mean age of 70.2?years. Patients underwent a clinical neurological evaluation and radiological imaging of the carotid arteries before the CAS procedure. Of the patients 80 (44?%) were asymptomatic. The median clinical and carotid Doppler ultrasound (DUS) follow-up period was 64?months (range 18–124?months). Results In 182?patients CAS were performed, 4 patients (2.2?%) developed minor stroke, 2 patients (1.1?%) developed myocardial infarction but no major stroke or death occurred in the following 30-day period. Asymptomatic restenosis was detected in seven patients (3.8?%) in the follow-up period. Conclusion With sufficient neurological evaluation during pretreatment and posttreatment periods and when the procedure is performed with technologically developed products by an experienced interventional team, CAS is beneficial in patients with ICA NO.