Feasibility of Endovascular Recanalization for Symptomatic Cervical Internal Carotid Artery Occlusion

Hsien Li Kao, Mao Shin Lin, Chia Sung Wang, Yen Hong Lin, Lung Chun Lin, Chia Lun Chao, Jiann Shing Jeng, Ping Keung Yip, Shih Chung Chen

Research output: Contribution to journalArticle

54 Citations (Scopus)

Abstract

Objectives: This study sought to report technical details and clinical results of the first series of endovascular recanalization for cervical internal carotid artery (ICA) occlusion. Background: Cervical ICA occlusion is associated with impaired cerebral perfusion, which may lead to ischemic cerebral symptoms and hemodynamic infarcts. Neither surgical nor endovascular revascularization has been shown to benefit this population. Methods: Endovascular recanalization was attempted in 30 patients with ICA occlusions (27 men; age 72.1 ± 8.0 years, range 48 to 85 years). Recurrent neurologic deficit or cerebral ischemia by perfusion study, after known ICA occlusion, was noted in all patients. Strategies and devices for coronary occlusion intervention were applied, including microcatheter-supported tapered-tip stiff coronary guidewires. Contralateral ICA stenosis was found in 9 patients (30%). All patients underwent independent neurologic and duplex ultrasound follow-up. Results: The overall technical success rate was 73% (22 of 30). No neck hematoma, intracranial hemorrhage, or hyperperfusion was noted. One (3.3%) fatal brainstem infarction occurred 1 day after a successful ICA procedure, with angiographically proven acute basilar artery occlusion and patent ICA stent. Baseline ophthalmic artery flow was reversed in 15 of the 22 successfully recanalized patients, and was normalized in 12 after the procedure. There was no new cerebral ischemic event or neurologic death for a mean follow-up of 16.1 ± 18.5 months. Conclusions: Endovascular recanalization for cervical ICA occlusion is feasible with acceptable midterm clinical results.

Original languageEnglish
Pages (from-to)765-771
Number of pages7
JournalJournal of the American College of Cardiology
Volume49
Issue number7
DOIs
Publication statusPublished - Feb 20 2007

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Internal Carotid Artery
Nervous System
Perfusion
Brain Stem Infarctions
Ophthalmic Artery
Basilar Artery
Intracranial Hemorrhages
Carotid Stenosis
Coronary Occlusion
Neurologic Manifestations
Brain Ischemia
Hematoma
Stents
Neck
Hemodynamics
Equipment and Supplies
Population

ASJC Scopus subject areas

  • Nursing(all)

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Feasibility of Endovascular Recanalization for Symptomatic Cervical Internal Carotid Artery Occlusion. / Kao, Hsien Li; Lin, Mao Shin; Wang, Chia Sung; Lin, Yen Hong; Lin, Lung Chun; Chao, Chia Lun; Jeng, Jiann Shing; Yip, Ping Keung; Chen, Shih Chung.

In: Journal of the American College of Cardiology, Vol. 49, No. 7, 20.02.2007, p. 765-771.

Research output: Contribution to journalArticle

Kao, HL, Lin, MS, Wang, CS, Lin, YH, Lin, LC, Chao, CL, Jeng, JS, Yip, PK & Chen, SC 2007, 'Feasibility of Endovascular Recanalization for Symptomatic Cervical Internal Carotid Artery Occlusion', Journal of the American College of Cardiology, vol. 49, no. 7, pp. 765-771. https://doi.org/10.1016/j.jacc.2006.11.029
Kao, Hsien Li ; Lin, Mao Shin ; Wang, Chia Sung ; Lin, Yen Hong ; Lin, Lung Chun ; Chao, Chia Lun ; Jeng, Jiann Shing ; Yip, Ping Keung ; Chen, Shih Chung. / Feasibility of Endovascular Recanalization for Symptomatic Cervical Internal Carotid Artery Occlusion. In: Journal of the American College of Cardiology. 2007 ; Vol. 49, No. 7. pp. 765-771.
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AU - Lin, Yen Hong

AU - Lin, Lung Chun

AU - Chao, Chia Lun

AU - Jeng, Jiann Shing

AU - Yip, Ping Keung

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N2 - Objectives: This study sought to report technical details and clinical results of the first series of endovascular recanalization for cervical internal carotid artery (ICA) occlusion. Background: Cervical ICA occlusion is associated with impaired cerebral perfusion, which may lead to ischemic cerebral symptoms and hemodynamic infarcts. Neither surgical nor endovascular revascularization has been shown to benefit this population. Methods: Endovascular recanalization was attempted in 30 patients with ICA occlusions (27 men; age 72.1 ± 8.0 years, range 48 to 85 years). Recurrent neurologic deficit or cerebral ischemia by perfusion study, after known ICA occlusion, was noted in all patients. Strategies and devices for coronary occlusion intervention were applied, including microcatheter-supported tapered-tip stiff coronary guidewires. Contralateral ICA stenosis was found in 9 patients (30%). All patients underwent independent neurologic and duplex ultrasound follow-up. Results: The overall technical success rate was 73% (22 of 30). No neck hematoma, intracranial hemorrhage, or hyperperfusion was noted. One (3.3%) fatal brainstem infarction occurred 1 day after a successful ICA procedure, with angiographically proven acute basilar artery occlusion and patent ICA stent. Baseline ophthalmic artery flow was reversed in 15 of the 22 successfully recanalized patients, and was normalized in 12 after the procedure. There was no new cerebral ischemic event or neurologic death for a mean follow-up of 16.1 ± 18.5 months. Conclusions: Endovascular recanalization for cervical ICA occlusion is feasible with acceptable midterm clinical results.

AB - Objectives: This study sought to report technical details and clinical results of the first series of endovascular recanalization for cervical internal carotid artery (ICA) occlusion. Background: Cervical ICA occlusion is associated with impaired cerebral perfusion, which may lead to ischemic cerebral symptoms and hemodynamic infarcts. Neither surgical nor endovascular revascularization has been shown to benefit this population. Methods: Endovascular recanalization was attempted in 30 patients with ICA occlusions (27 men; age 72.1 ± 8.0 years, range 48 to 85 years). Recurrent neurologic deficit or cerebral ischemia by perfusion study, after known ICA occlusion, was noted in all patients. Strategies and devices for coronary occlusion intervention were applied, including microcatheter-supported tapered-tip stiff coronary guidewires. Contralateral ICA stenosis was found in 9 patients (30%). All patients underwent independent neurologic and duplex ultrasound follow-up. Results: The overall technical success rate was 73% (22 of 30). No neck hematoma, intracranial hemorrhage, or hyperperfusion was noted. One (3.3%) fatal brainstem infarction occurred 1 day after a successful ICA procedure, with angiographically proven acute basilar artery occlusion and patent ICA stent. Baseline ophthalmic artery flow was reversed in 15 of the 22 successfully recanalized patients, and was normalized in 12 after the procedure. There was no new cerebral ischemic event or neurologic death for a mean follow-up of 16.1 ± 18.5 months. Conclusions: Endovascular recanalization for cervical ICA occlusion is feasible with acceptable midterm clinical results.

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