Endovascular Treatment for Near Occlusion of the Internal Carotid Artery : 30-Day Outcome and Long-Term Follow-Up

Clin Neuroradiol. 2018 Jun;28(2):245-252. doi: 10.1007/s00062-016-0546-8. Epub 2016 Oct 25.

Abstract

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.

Keywords: Carotid artery stenosis; Carotid artery stenting; Endovascular therapy; Outcome; Pseudo-occlusion.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carotid Artery, Internal*
  • Carotid Stenosis / complications
  • Carotid Stenosis / therapy*
  • Endarterectomy, Carotid*
  • Female
  • Follow-Up Studies
  • Humans
  • Japan
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stents
  • Stroke / etiology
  • Treatment Outcome