Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Neurology, Sejong General Hospital, Bucheon, Gyeonggi-do, Republic of Korea.
J Neurointerv Surg. 2018 Jan;10(1):39-43. doi: 10.1136/neurintsurg-2016-012900. Epub 2017 Jan 20.
Endovascular recanalization of a completely occluded proximal internal carotid artery (ICA) with underlying stenosis may be challenging owing to a possible thrombotic component. This is especially true when the landing zone for a balloon-tipped guiding catheter (BGC) at the bulb portion is insufficient. Sequential application of the balloons of a BGC and an angioplasty catheter may prevent thromboembolism during revascularization. This study analyzed the safety and effectiveness of this relay-balloon technique.
Ten consecutive patients with acute symptomatic proximal ICA occlusion were treated by the relay-balloon technique. Outcomes analyzed included technical success rate, procedure-related complications, and short-term clinical outcomes.
Successful revascularization was achieved in all 10 patients. One patient experienced a post-procedural infarct extension, but there was no change in National Institutes of Health Stroke Scale (NIHSS) score. Mean NIHSS score decreased from 12.0±5.6 (range 0-18) initially to 6.8±5.4 (range 0-18) at discharge.
The relay-balloon technique is safe and effective in the endovascular revascularization of acute symptomatic proximal ICA occlusions, which are at high risk of distal thromboembolism due to insufficient landing zone for the BGC.
由于可能存在血栓成分，完全闭塞的颈内动脉（ICA）近端血管内再通可能具有挑战性，尤其是当球囊尖端引导导管（BGC）在球部的着陆区不足时。依次应用 BGC 和血管成形术导管的球囊可能会在再通过程中防止血栓栓塞。本研究分析了这种接力球囊技术的安全性和有效性。
10 例急性症状性颈内动脉近端闭塞患者采用接力球囊技术治疗。分析的结果包括技术成功率、与操作相关的并发症和短期临床结果。
10 例患者均成功进行了再通。1 例患者出现术后梗死延伸，但 NIHSS 评分无变化。平均 NIHSS 评分从初始的 12.0±5.6（范围 0-18）降至出院时的 6.8±5.4（范围 0-18）。
在因 BGC 着陆区不足而存在远端血栓栓塞高风险的急性症状性颈内动脉近端闭塞的血管内再通中，接力球囊技术是安全有效的。
