Carotid Artery Stenting for Symptomatic Carotid Near Occlusions: Feasibility, Safety and Outcome Analysis

Overview

Journal Interv Neuroradiol

Publisher Sage Publications

Specialty Neurology

Date 2024 Oct 21

PMID 39431297

Authors

Emre Can Celebioglu

Guilherme Dabus

Sena Bozer Uludag

Omer Arda Cetinkaya

Sena Unal

Ugur Bengisun

Sadik Eryilmaz

Mine Hayriye Sorgun

Ihsan Dogan

Sermin Atmaca

Evren Ozcinar

Basak Ceyda Meco

Mustafa Bahadir Inan

Canan Togay Isikay

Ahmet Ruchan Akar

Iskender Alacayir

Sadik Bilgic

Affiliations

Soon will be listed here.

Abstract

Introduction: Extracranial internal carotid stenosis (EICS) is a well-established cause of stroke. Carotid near-occlusion (CNO), either distally collapsed or not, is a rare sub-type of EICS with conflicting data regarding the necessity for treatment. The aim of this study is to evaluate the results of carotid artery stenting (CAS) for patients with symptomatic CNOs.

Material And Methods: Institutional review board (I06-420-23) approval was obtained for this retrospective study. Consecutive data from January 2019 to January 2023 was obtained. Sixty-five patients underwent 66 procedures for symptomatic CNOs. Diagnosis of CNOs were made with DSA images. Treatment decisions were made by a multidisciplinary team. Patient data including age, gender, clinical presentation, affected side, complications (initial/ follow-up), and pre and post mRS scores were recorded and analyzed.

Results: There were 22 female and 43 male patients with symptomatic CNOs (mean age: 71.52 ± 9.32 years). The mean time from symptom-to-treatment was 3.91 weeks ± 3.74 weeks (ranging from 0 to 20 weeks). There were eight events recorded in the 30 days period after CAS; five (7.7%) were cerebral hyperperfusion syndrome (one causing haemorrhage) and three (4.5%) ischemic complications. Permanent neurologic deficit rate was 6% and 61 patients (94%) mRS scores were unchanged during last follow-up. Mean follow-up period was 22.94 ± 16.67 months (ranging from 0.5 to 60 months).

Conclusion: Our study demonstrated that in the complex population of patients with symptomatic CNOs, CAS is a feasible option with acceptable rate of permanent neurologic deficits. Further studies are needed to assess its safety and long-term efficacy.

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