Liu Lijuan, Zhang Kun, Su Xudong, Yu Jianghua, Liu Zengpin, Zhou Cunhe, Wang Binbin, Zhao Yanying, Chen Ruomeng, Zhou Zhou, Zhao Minghan, Liu Xiaoyun
Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, China.
Department of Neurology, Hebei Hospital of Xuanwu Hospital Capital Medical University, Shijiazhuang, China.
Medicine (Baltimore). 2025 Sep 5;104(36):e44247. doi: 10.1097/MD.0000000000044247.
Chronic cerebral artery occlusion is an important cause of cerebral ischemic events. Endovascular recanalization is an effective treatment for this condition, but its success depends on appropriate patient selection and assessment. This is a retrospective study that collected patients with chronic cerebral artery occlusion who underwent endovascular recanalization to determine how imaging features from computed tomography angiography - including the extent of internal carotid artery occlusion, the number of calcified vessels, and the degree of calcification in the occluded vessels - affect the success rate of recanalization. A total of 147 patients were included, 103 (70.1%) were successfully recanalized. Lipoprotein(a) (Lp[a]) levels were significantly higher in the failed group (38.40 ± 34.41 mg/dL) compared to the successful group (22.93 ± 22.84 mg/dL) (P = .008). Among these patients, 49 underwent preoperative CTA, and 36 (73.5%) achieved successful recanalization. There was no significant association between the number of calcified vessels and the endovascular recanalization rate (P = 1.000). However, patients with a calcification degree >50% had a lower recanalization rate (40%) than those with 50% or less calcification (82.1%, P = .014), and the same result was seen in patients with chronic anterior circulation large artery occlusion (P = .019). In patients with chronic intracranial and extracranial large artery occlusion, the degree of vascular calcification in the occluded vessels significantly influences the success of endovascular recanalization.
慢性脑动脉闭塞是脑缺血事件的重要原因。血管内再通是治疗该病的有效方法，但其成功取决于合适的患者选择和评估。这是一项回顾性研究，收集了接受血管内再通治疗的慢性脑动脉闭塞患者，以确定计算机断层血管造影的影像特征——包括颈内动脉闭塞程度、钙化血管数量以及闭塞血管的钙化程度——如何影响再通成功率。共纳入147例患者，103例（70.1%）成功再通。失败组的脂蛋白(a)（Lp[a]）水平（38.40±34.41mg/dL）显著高于成功组（22.93±22.84mg/dL）（P = 0.008）。在这些患者中，49例术前行CTA检查，36例（73.5%）成功再通。钙化血管数量与血管内再通率之间无显著相关性（P = 1.000）。然而，钙化程度>50%的患者再通率（40%）低于钙化程度≤50%的患者（82.1%，P = 0.014），慢性前循环大动脉闭塞患者也有同样的结果（P = 0.019）。在慢性颅内和颅外大动脉闭塞患者中，闭塞血管的血管钙化程度显著影响血管内再通的成功率。
