gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

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Endovascular revascularization of chronic near or complete occlusion of the internal carotid artery

Meeting Abstract

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  • S. Nemoto - Endovascular Surgery, Tokyo Medical and Dental University, Tokyo, Japan

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocP 059

doi: 10.3205/12dgnc446, urn:nbn:de:0183-12dgnc4468

Published: June 4, 2012

© 2012 Nemoto.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Near or complete occlusion of the internal carotid artery is not a good candidate for surgical treatment. No definite treatment is available for complete occlusion of the internal carotid artery except for acute occlusion. Our experience with endovascular revascularization of these chronic lesions is presented.

Methods: Endovascular revascularization was performed in 32 patients with near occlusion and 26 with chronic complete occlusion. A guide wire was advanced through the occluded internal carotid artery. With proximal and distal protection sequential angioplasty was performed. Carotid stent and coronary stent were deployed to the residual stenosis. Patients were followed up with angiography or 3D-CT.

Results: Technical success was obtained in all near occlusion and in 22 out of 26 complete occlusion. Complications were observed in three. One with retinal ischemia and two with transient hemiparesis. In follow-up, patency of the vessel was confirmed in all near occlusion and in 21 of 22 complete occlusion. Hemorrhagic stroke occurred in one patient who were on Coumadin. Ischemic stroke occurred in one with complete occlusion. Other patients were free from stroke after treatment.

Conclusions: Endovascular revascularization is promising for chronic near or complete occlusion of the internal carotid artery.