Clinical Analysis Of Interventional Recanalization In 21 Patients With Chronic Internal Carotid Artery Occlusion

Objective 1.To explore the necessity of interventional recanalization in patients with chronic carotid occlusion.2.To investigate the feasibility,safety and efficacy of interventional recanalization in patients with chronic carotid occlusion.3.To explore the surgical methods of interventional recanalization in patients with chronic carotid occlusion.Methods Retrospective analysis of the clinical data of interventional recanalization for patients with chronic carotid artery occlusion in the general hospital of Ning Xia medical university from January 2011 to February 2020,clinical analysis of interventional recanalization success rate,complications,operation mode and follow-up results.Results 95.2 percent(20/21)of men and 4.8 per cent(1/21)of women with chronic carotid of chronic carotid occlusion with routine interventional recanalization,with an average age of58.9±1.9 years.There were 14 cases of hypertension,4 cases of diabetes,3 cases of coronary heart disease,8 cases of long-term smoking and 3 cases of drinking alcohol.Atherosclerosis in the major arteries accounted for 85.8%(18 cases)and dissection for 14.3%(3 cases).Clinical manifestations were cerebral infarction of 85.8%(18/21),TIA of 4.8%(1/21),cognitive dysfunction of 4.8%(1/21),no clinical manifestations but decreased perfusion of 4.8%(1/21).the overall success rate of surgery in 21 patients with chronic carotid artery occlusion was 76.2%,the incidence of complications during the perioperative period of 30 days was 14.3%(3/21),and the incidence of restenosis during follow-up was 0%.the interventional recanalization success A type 100%(7/7);B type 83%(5/6);C type 80%(4/5);and D type 0%.the success rate of balloon dilatation alone was 83%(5/6),the success rate of stent placement in stage I of balloon dilatation was 66.7%(6/9),that in stage II of balloon dilatation was 66.7%(2/3),and that in bolus aspiration was 100%(3/3).he incidence of complications during the 30-day perioperative period was 14.3%(3/21).One patient with type B occlusion had restlessness during the operation with simple balloon dilatation,and the head CT had high perfusion syndrome immediately after operation.An acute reocclusion occurred in type A with stage I stent implantation.One patient with type C underwent stage I balloon dilation +stage II stent implantation,after stage I operation 2 weeks,CTA suggesting vascular occlusion,the rate of restenosis during follow-up was 0%.Conclusion 1.The necessity of interventional recanalization for some chronic carotid artery occlusion.2.interventional recanalization for chronic carotid occlusion may be safe and effective,and imaging morphologic typing may be a method to evaluate the feasibility and safety of interventional recanalization.3.Interventional recanalization of chronic carotid artery occlusion may require individualized choice.