Clinical effect of endovascular revascularization in treatment for symptomatic chronic cerebrovascular artery occlusion

doi:10.3877/cma.j.issn.2095-5782.2018.04.010

Abstract

Abstract:

Objective:

To evaluate the curative effect and safety of endovascular revascularization in treatment of symptomatic chronic cerebrovascular artery occlusion, and to summarize the collateral circulations for symptomatic chronic cerebrovascular artery occlusion.

Methods:

The retrospective study was conducted including 27 consecutive patients with symptomatic chronic cerebrovascular artery occlusion treated with interventional reanalization, admitted to Tianjin First Central Hospital during the period from December 2008 to December 2017. The rate of recanalization and perioperative complications were evaluated. The curative effect was evaluated using thrombolysis in cerebral infarction (TICI) score and modified Rankin Scale (mRS) before and after operation.

Results:

Of the 27 patients, 6 of the upper segment of internal carotid artery were occluded, occlusion of vertebral basilar artery junction happened in 7 cases, bilateral vertebral artery intracranial or superior side occlusion occurred in 8 cases, occlusion of the middle cerebral artery happened in 6 cases, and 25 cases of intracranial occlusive vessels were successfully opened, with TICI upgraded from grade 0 to 3. The operation modes were interventional stent and balloon angioplasty. Two patients died owing to the perioperative complication. In 2 years follow-up, 20 patients reported good outcome (mRS score: 0-1) . Two patients had moderate outcome (mRS score: 2-3) and one had poor outcome (mRS score: 4-5) . No death occurred during the follow-up period. Collateral circulations for chronic cerebrovascular artery occlusion included supraclinoid segment of the internal carotid artery (n=6) , borderline of vertebrobasilar artery (n=7) , bilateral vertebral artery intracranial segment or dominant side (n=8) and middle cerebral artery level segment (n=6) .

Conclusions:

Endovascular reanalization for symptomatic chronic cerebrovascular artery occlusion seems to demonstrate technical feasibility and safety for particular patients, however, there are still some complications after the operation. A large number of clinical data still need to be confirmed.

Key words: Intracranial artery, Chronic occlusion, Interventional therapy, Follow up study

Binge Chang, Chen Wang, Zhiguo Sheng, Baosheng Zhou, Jingjian Ma, Mu Li. Clinical effect of endovascular revascularization in treatment for symptomatic chronic cerebrovascular artery occlusion[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2018, 06(04): 324-328.

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