Hybrid operation to revascularize long-segment occluded internal carotid artery prevent further ischemic events

Zhang, Kun; Gao, Bu-Lang; Zhao, Tongyuan; Li, Tianxiao; Xue, Jiangyu; He, Yingkun; Cai, Dongyang; Yang, Baoxue

doi:10.1007/s00234-018-2145-7

Cited by 13 publications

(19 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For types A and B, the successful recanalization rate using ET was 95.4% (95% CI: 86.5%–100%) with a 13.7% (95% CI: 2.3%–27.4%) complication rate (Table 3). For type C, the success rate for ET was 45.7% (95% CI: 17.8%–70.7%), with a complication rate of 46.0% (95% CI: 20.0%–71.4%) for ET; however, for the HS technique that was developed to treat specifically type C patients, the overall success based on the 5 studies 25 , 29, 30, 31, 32 was 87.6% (95% CI: 80.9%–94.4%), with a complication rate of 14.0% (95% CI: 7.0%–21.8%). For type D, the success rate of recanalization was 29.8% (95% CI: 7.8%–52.8%), with a 29.8% (95% CI: 6.1%–56.3%) complication rate.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Recanalization of the Chronically Occluded Internal Carotid Artery: Review of the Literature

Zanaty

Roa

Jabbour

et al. 2020

World Neurosurgery: X

View full text Add to dashboard Cite

IntroductionWe reviewed the literature on interventions for patients with medically refractory chronically occluded internal carotid artery (COICA) to assess the risks and/or benefits after recanalization via an endovascular technique (ET) or hybrid surgery (HS, i.e., ET plus carotid endarterectomy).MethodsA systematic search of the electronic databases was performed. Patients with COICA were classified into 4 different categories according to Hasan et al classification.ResultsEighteen studies satisfied the inclusion criteria. Only 6 studies involved an HS procedure. We identified 389 patients with COICA who underwent ET or HS; 91% were males. The overall perioperative complication rate was 10.1% (95% confidence interval [CI]: 7.4%–13.1%). For types A and B, the successful recanalization rate was 95.4% (95% CI: 86.5%–100%), with a 13.7% (95% CI: 2.3%–27.4%) complication rate. For type C, the success rate for ET was 45.7% (95% CI: 17.8%–70.7%), with a complication rate of 46.0% (95% CI: 20.0%–71.4%) for ET and for the HS technique 87.6% (95% CI: 80.9%–94.4%), with a complication rate of 14.0% (95% CI: 7.0%–21.8%). For type D, the success rate of recanalization was 29.8% (95% CI: 7.8%–52.8%), with a 29.8% (95% CI: 6.1%–56.3%) complication rate. Successful recanalization resulted in a symmetrical perfusion between both cerebral hemispheres, resolution of penumbra, normalization of the mean transit time, and improvement in Montreal Cognitive Assessment (MoCA) score (ΔMoCA = 9.80 points; P = 0.004).ConclusionsType A and B occlusions benefit from ET, especially in the presence of a large penumbra. Type C occlusions can benefit from HS. Unfortunately, we did not identify an intervention to help patients with type D occlusions. A phase 2b randomized controlled trial is needed to confirm these findings.

show abstract

Section: Resultsmentioning

confidence: 99%

“…The efficacy of HS is yet to be determined given the low number of patients and the different techniques used. Whereas Zanaty et al 34 and Liu et al 29 performed HS on type C occlusions only, Zhang et al 30 performed it on a variety of COICAs. All 3 authors reported good outcomes.…”

Section: Discussionmentioning

confidence: 99%

Recanalization of the Chronically Occluded Internal Carotid Artery: Review of the Literature

Zanaty

Roa

Jabbour

et al. 2020

World Neurosurgery: X

View full text Add to dashboard Cite

show abstract

“…This is an earlier reported success, but with a small sample size. In 2018, Zhang et al ( 88 ) divided 65 patients with long ICA occlusion into revascularization hybrid surgery ( n = 30) and medication ( n = 35) groups to analyze clinical and angiographic data. The vascular recanalization rate of the patients who underwent hybrid surgery was 100%, with 2 complications in the perioperative period.…”

Section: Surgical Therapeutic Strategymentioning

confidence: 99%

“…A total of eight studies were controlled studies, nine were single-arm studies and two were retrospective analysis studies. Among the eight controlled studies, endovascular treatment was performed in three studies ( 82 , 83 , 88 ) and EC-IC bypass was performed in five studies ( 21 , 57 , 58 , 62 , 95 ). Among the nine single-arm studies, endovascular treatment was performed in seven studies ( 14 , 83 , 86 , 95 – 97 ) and EC-IC bypass was performed in two studies ( 61 , 100 ).…”

Section: Comparisonmentioning

confidence: 99%

Spotlight on clinical strategies of Chronic Internal Carotid Artery Occlusion: Endovascular interventions and external-intracarotid bypasses compared to conservative treatment

Fang²,

Wei³

et al. 2022

Front. Surg.

View full text Add to dashboard Cite

Chronic internal carotid artery occlusion (CICAO) has high prevalence and incidence rates, and patients with CICAO can be completely asymptomatic, experience a devastating stroke or die. It is important to note that CICAO causes cerebrovascular accidents. Currently, the external carotid-internal carotid (EC-IC) bypass technique is used to treat CICAO. However, many clinical studies showed that EC-IC bypass was not beneficial for many patients with CICAO. Meanwhile, endovascular intervention treatment options for CICAO are evolving, and an increasing number of patients are undergoing endovascular intervention therapy. Accordingly, a review comparing both techniques is warranted. For this review, we searched PubMed and collected relevant case study reports comparing endovascular interventional therapy and internal and external cervical bypass surgeries to provide strategies for clinical treatment.

show abstract

“…Evaluating a hybrid operation (endarterectomy and carotid stenting) to recanalize internal carotid artery occlusions, this hybrid procedure implemented at an average of 41 days (ranging from 17-120 days) after symptom onset resulted in 100% recanalization and mRS scores improved from 3.4 ± 0.6 at admission to 2.5 ± 0.6 at 3-months from symptom onset. 39…”

Section: Delayed Reperfusion: Research/casesmentioning

confidence: 99%

Evolution of the stroke paradigm: A review of delayed recanalization

Camara

Matei

Zhang

2020

J Cereb Blood Flow Metab

View full text Add to dashboard Cite

While the time window for reperfusion after ischemic stroke continues to increase, many patients are not candidates for reperfusion under current guidelines that allow for reperfusion within 24 h after last known well time; however, many case studies report favorable outcomes beyond 24 h after symptom onset for both spontaneous and medically induced recanalization. Furthermore, modern imaging allows for identification of penumbra at extended time points, and reperfusion risk factors and complications are becoming better understood. Taken together, continued urgency exists to better understand the pathophysiologic mechanisms and ideal setting of delayed recanalization beyond 24 h after onset of ischemia.

show abstract

Hybrid operation to revascularize long-segment occluded internal carotid artery prevent further ischemic events

Cited by 13 publications

References 22 publications

Recanalization of the Chronically Occluded Internal Carotid Artery: Review of the Literature

Recanalization of the Chronically Occluded Internal Carotid Artery: Review of the Literature

Spotlight on clinical strategies of Chronic Internal Carotid Artery Occlusion: Endovascular interventions and external-intracarotid bypasses compared to conservative treatment

Evolution of the stroke paradigm: A review of delayed recanalization

Contact Info

Product

Resources

About