Observation on the effect of endovascular treatment for non-acute symptomatic anterior intracranial circulatory artery occlusion / 中风与神经疾病杂志

ABSTRACT

@#To investigate the safety and effectiveness of endovascular treatment for non-acute symptomatic intracranial occlusive disease of internal carotid artery. Methods The general data，surgical data and follow-up data of the patients with non-acute intracranial occlusion of internal carotid artery admitted to the Affiliated Hospital of Qingdaso Univerity from July 2016 to February 2021 were retrospectively analyzed，including the success rate of recanalization，the incidence of perioperative complications，imaging follow-up data and clinical follow-up data. Thrombolysis test for cerebral infarction （TICI） was used to evaluate the success of recanalization，the National Institutes of Health Stroke Scale （NIHSS） score was used to evaluate the degree of neurological impairment before and after treatment，and the degree of postoperative neurological recovery was evaluated by the modified Rankin Scale （MRS）. Results 28 of the 30 cases of intracranial internal carotid artery were successfully opened （technical success rate was 93.3%）. The difference of mTICI grading before operation was statistically significant compared with that after operation （P<0.05）.Surgical complications occurred in 6 cases （20.0%），including dissection in 2 cases，hyperperfusion syndrome in 1 case，and subarachnoid hemorrhage in 3 cases. Follow-up imaging of the 18 patients showed that 3 patients had restenosis of the offending vessels. One of them had TIA in the offending vessels and presented with paroxysmic contralateral limb weakness，and the other one had asymptomatic stenosis. In the 30 cases of clinical follow-up，there was a statistically significant difference in the MRS score between the 28 cases with successful operation and that before operation （P<0.05），and there was no significant change in the MRS score during clinical follow up between the 2 cases with intraoperative complications and unsuccessful operation. Conclusion endovascular therapy is safe and effective in highly selected cases of non-acute symptomatic intracranial internal carotid occlusion. The long-term NIHSS score and MRS score can be used to follow up the neurological deficit and recovery，and then to evaluate the long-term efficacy of endovascular therapy.