| BackgroundInternal carotid artery occlusion(ICAO)is one of the major causes in ischemic stroke.Since Fisher first reported atherosclerotic ICAO in1954 and Terada reported the first intravascular intervention for ICAO in2005,conservative treatment and surgical treatment of ICAO have always been the bone of contention among neurosurgery scholars.According to the results of relevant clinical studies,it has been proved that the probability of recurrent severe cerebral ischemia in ICAO patients is11.5% after they have suffered TIA before,and the risk of surgical treatment is far lower than the risk of natural disease development.Other relevant reports suggest that simple internal carotid endarterectomy has a low recanalization rate and high mortality rate in the treatment of ICAO,and is limited by a variety of factors,while intracranial-extracranial bypass grafting is further not recommended or even given up by surgeons.In recent years,with the accumulation of experience and techniques of neuro-intervention doctors,and the rapid development of intervention materials and imaging,the intravascular interventional therapy of ICAO has gradually become popular among neurosurgeons.Most scholars believe that the implementation of endovascular recanalization in ICAO patients is relatively safe.In this way,it can obtain more obvious therapeutic effects than internal medicine,and significantly improve the blood supply of the brain as well as promote the recovery of nerve function.ObjectiveTo study the curative effect of endovascular treatment for ICAO and simply compare the curative effect of absolute medicine therapy.MethodsTwenty-four ICAO patients who were admitted to the Neurosurgery Department of the Second Hospital of Jilin University from September2015 to September 2017 have been collected and divided into recanalization group and non-recanalization group.Researchers collected general data when admission,and according to the clinical manifestations of patients before and after treatment for 3 months and 7 days,the modified Rankin scale and the Montreal cognitive assessment scale have been used for grading and statistical analysis.Results(1)A total of 24 patients with chronic internal carotid artery occlusion were studied for this research.Among them,a total of 19 patients underwent intravascular intervention recanalization,15 cases were successful and the success rate was 78.9%.And other 9 patients were treated with conservative drugs,including 4 patients with chronic internal carotid artery occlusion failure and 5 patients with drug therapy.(2)Patients in the recanalization group with 3 month after surgery,the MRS score was(1.07±0.96)superior than that of before(3.00±0.65),the neurological function had been obviously improved.(3)Patients in the recanalization group with 3 month after treat,the MRS score declined(1.93±0.70)significantly higher than that of non-recanalization(0.67±0.87),the statistical differences(p < 0.01)indicating that recanalization surgery can promote neural functional recovery more obviously than drug treatment.(4)Patients in the recanalization groupwith 7 days after surgery,the Montreal cognitive assessment score was(22.53±3.85)superior than that of before(19.33±3.75),the cognitive function had been obviously improved.(5)Patients in the recanalization group with 7 days after treat,the Montreal cognitive assessment score improved(3.20±2.30)significantly higher than that of non-recanalization(0.89±1.90),the statistical differences(p < 0.05)indicating that recanalization surgery can promote cognitive functional recovery more obviously than drug treatment.Conclusion(1)For patients with symptomatic chronic internal carotid artery occlusion,under the premise of strictly grasping surgical indications,intravascular interventional recanalization surgery has fewer complications,high success rate,and can significantly improve neurological function and cognitive function.(2)For patients with symptomatic chronic internal carotid artery occlusion,the intravascular interventional therapy can more significantly improve neurological function and cognitive function than drug therapy in a short term. |
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