Department of Neurosurgery, Tianjin Huanhu Hospital.
Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Disease, Tianjin, China.
J Craniofac Surg. 2024;35(1):168-171. doi: 10.1097/SCS.0000000000009760. Epub 2023 Oct 9.
The aim of this study was to conclude the safety and effectiveness of hybrid surgery for revascularization of chronic occlusion of internal carotid artery (COICA).
A total of 56 COCIA patients underwent hybrid surgery (carotid endarterectomy+carotid artery stenting) from September 2017 to September 2021 in our department. The clinical material and radiology data (preoperation and postoperation) were retrospectively analyzed to conclude the safety and effectiveness of hybrid surgery for revascularization of COICA.
All 56 patients underwent hybrid surgery got revascularization successfully (with a successful rate of 100%) and improved intracranial blood flow. The computed tomography perfusion results indicate that the postoperative cerebral blood flow perfusion of the patient is significantly improved compared with before surgery. In 1 patient, postoperative brain magnetic resonance imaging within 24 hours showed spotted fresh infarction with head magnetic resonance imaging, without any clinical symptoms; 3 patients developing symptoms of ipsilateral neural-functional defect (hypoglossal nerve, superior laryngeal nerve, and mandibular branch of facial nerve, respectively), 2 weeks later the symptoms were disappeared. Imaging study at 3 and 6 months during the follow-up showed no abnormalities.
Hybrid surgery is safe and effective for revascularization of COICA.
本研究旨在总结颈内动脉慢性闭塞（COICA）血运重建杂交手术的安全性和有效性。
2017 年 9 月至 2021 年 9 月，我科对 56 例 COICA 患者行杂交手术（颈动脉内膜切除术+颈动脉支架置入术），回顾性分析其临床资料和影像学资料（术前、术后），总结 COICA 血运重建杂交手术的安全性和有效性。
56 例患者均成功实施杂交手术（成功率 100%），实现血运重建，改善颅内血流。CT 灌注结果显示，术后患者脑血流灌注明显改善。1 例患者术后 24 小时内头颅磁共振成像显示点状新鲜梗死，无任何临床症状；3 例患者出现同侧神经功能缺损症状（舌下神经、喉上神经和面神经下颌支），2 周后症状消失。随访 3 个月和 6 个月的影像学检查未见异常。
杂交手术是治疗 COICA 的安全、有效的方法。
