Çelebioğlu Emre Can, Dabus Guilherme, Bozer Uludağ Sena, Çetinkaya Ömer Arda, Ünal Sena, Bengisun Uğur, Eryılmaz Sadık, Sorgun Mine Hayriye, Doğan İhsan, Atmaca Şermin, Özçınar Evren, Meço Başak Ceyda, İnan Mustafa Bahadır, Togay Işıkay Canan, Akar Ahmet Rüçhan, Alaçayır İskender, Bilgiç Sadık
Department of Radiology/Vascular Interventional, Ankara Universitesi Tip Fakultesi, Ankara, Turkey.
Interventional Neuroradiology, Miami Neuroscience Institute and Miami Cardiac & Vascular Institute - Baptist Health of South Florida, Miami, Florida, USA.
Interv Neuroradiol. 2024 Oct 21:15910199241292387. doi: 10.1177/15910199241292387.
Extracranial internal carotid stenosis (EICS) is a well-established cause of stroke. Carotid near-occlusion (CNO), either distally collapsed or not, is a rare sub-type of EICS with conflicting data regarding the necessity for treatment. The aim of this study is to evaluate the results of carotid artery stenting (CAS) for patients with symptomatic CNOs.
Institutional review board (I06-420-23) approval was obtained for this retrospective study. Consecutive data from January 2019 to January 2023 was obtained. Sixty-five patients underwent 66 procedures for symptomatic CNOs. Diagnosis of CNOs were made with DSA images. Treatment decisions were made by a multidisciplinary team. Patient data including age, gender, clinical presentation, affected side, complications (initial/ follow-up), and pre and post mRS scores were recorded and analyzed.
There were 22 female and 43 male patients with symptomatic CNOs (mean age: 71.52 ± 9.32 years). The mean time from symptom-to-treatment was 3.91 weeks ± 3.74 weeks (ranging from 0 to 20 weeks). There were eight events recorded in the 30 days period after CAS; five (7.7%) were cerebral hyperperfusion syndrome (one causing haemorrhage) and three (4.5%) ischemic complications. Permanent neurologic deficit rate was 6% and 61 patients (94%) mRS scores were unchanged during last follow-up. Mean follow-up period was 22.94 ± 16.67 months (ranging from 0.5 to 60 months).
Our study demonstrated that in the complex population of patients with symptomatic CNOs, CAS is a feasible option with acceptable rate of permanent neurologic deficits. Further studies are needed to assess its safety and long-term efficacy.
颅外颈内动脉狭窄（EICS）是公认的中风病因。颈动脉近乎闭塞（CNO），无论远端是否塌陷，是EICS的一种罕见亚型，关于治疗必要性的数据相互矛盾。本研究的目的是评估有症状CNO患者的颈动脉支架置入术（CAS）结果。
本回顾性研究获得机构审查委员会（I06 - 420 - 23）批准。获取了2019年1月至2023年1月的连续数据。65例患者因有症状CNO接受了66次手术。通过数字减影血管造影（DSA）图像诊断CNO。治疗决策由多学科团队做出。记录并分析患者数据，包括年龄、性别、临床表现、患侧、并发症（初始/随访）以及改良Rankin量表（mRS）评分前后情况。
65例有症状CNO患者中，女性22例，男性43例（平均年龄：71.52±9.32岁）。从症状出现到治疗的平均时间为3.91周±3.74周（范围为0至20周）。CAS术后30天内记录到8起事件；5例（7.7%）为脑过度灌注综合征（1例导致出血），3例（4.5%）为缺血性并发症。永久性神经功能缺损率为6%，61例患者（94%）在最后一次随访时mRS评分未改变。平均随访期为22.94±16.67个月（范围为0.5至60个月）。
我们的研究表明，在有症状CNO的复杂患者群体中，CAS是一种可行的选择，永久性神经功能缺损率可接受。需要进一步研究来评估其安全性和长期疗效。
