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Hybrid operation to revascularize long-segment occluded internal carotid artery prevent further ischemic events
Purpose The effects and complications of hybrid procedure (combined carotid endarterectomy and carotid stenting) to revascularize chronic long-segment occlusion of internal carotid artery (ICA) are currently unknown and the purpose of this study. Methods Sixty-five patients with long-segment occlusi...
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| Published in: | Neuroradiology 2019-02, Vol.61 (2), p.217-224 |
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| container_title | Neuroradiology |
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| creator | Zhang, Kun Gao, Bu-Lang Zhao, Tong-Yuan Li, Tian-Xiao Xue, Jiang-Yu He, Ying-Kun Cai, Dong-Yang Yang, Bo-Wen |
| description | Purpose
The effects and complications of hybrid procedure (combined carotid endarterectomy and carotid stenting) to revascularize chronic long-segment occlusion of internal carotid artery (ICA) are currently unknown and the purpose of this study.
Methods
Sixty-five patients with long-segment occlusion of ICA were prospectively enrolled and divided into two groups of revascularization with hybrid operation (
n
= 30) and medication group (
n
= 35), and clinical and angiographic data were analyzed.
Results
The duration from symptom onset to revascularization ranged 17–120 days (mean 40.5 ± 5.0) in the hybrid operation, with a success revascularization rate of 100%. All patients had thrombi extracted with the clot length ranging 5–8 cm (mean 6.3 ± 0.9). The thrombolysis in cerebral infarction grade (TICI) was significantly (
P
|
| doi_str_mv | 10.1007/s00234-018-2145-7 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2157666942</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2157666942</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-650393cc02ecf9c84e6c23996fc4b8c88f02e09d2c0c8963777740668f5b4a303</originalsourceid><addsrcrecordid>eNp1kUtv1DAUhS1ERYfCD2CDLLFhY3r9iGMvUQUUqRKbdm15bm6mqZJ4sBOk4dfj6RSQkPDG0j3fOX4cxt5I-CAB2ssCoLQRIJ1Q0jSifcY20mglpFfwnG2q7IT2Bs7Zy1IeAEC3un3BzjU0jTLGbFi6Pmzz0PG0pxyXIc18STzTj1hwHWMefhIf07wThXYTzQtPiOPaUceHeaE8x5FjzGmpCTHXwYHvq_kI9mte7inzoeA9TQPyx3F5xc76OBZ6_bRfsLvPn26vrsXNty9frz7eCNStWoRtQHuNCIqw9-gMWVTae9uj2Tp0rq8K-E4hoPNWt3UZsNb1zdZEDfqCvT_l7nP6vlJZwlRvQuMYZ0prCUo2rbXWG1XRd_-gD2k9Pu2RsspZ0-hKyROFOZWSqQ_7PEwxH4KEcGwjnNoItY1wbCO01fP2KXndTtT9cfz-_gqoE1CqNO8o_z36_6m_AI9dlcs</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2156286453</pqid></control><display><type>article</type><title>Hybrid operation to revascularize long-segment occluded internal carotid artery prevent further ischemic events</title><source>Springer Link</source><creator>Zhang, Kun ; Gao, Bu-Lang ; Zhao, Tong-Yuan ; Li, Tian-Xiao ; Xue, Jiang-Yu ; He, Ying-Kun ; Cai, Dong-Yang ; Yang, Bo-Wen</creator><creatorcontrib>Zhang, Kun ; Gao, Bu-Lang ; Zhao, Tong-Yuan ; Li, Tian-Xiao ; Xue, Jiang-Yu ; He, Ying-Kun ; Cai, Dong-Yang ; Yang, Bo-Wen</creatorcontrib><description>Purpose
The effects and complications of hybrid procedure (combined carotid endarterectomy and carotid stenting) to revascularize chronic long-segment occlusion of internal carotid artery (ICA) are currently unknown and the purpose of this study.
Methods
Sixty-five patients with long-segment occlusion of ICA were prospectively enrolled and divided into two groups of revascularization with hybrid operation (
n
= 30) and medication group (
n
= 35), and clinical and angiographic data were analyzed.
Results
The duration from symptom onset to revascularization ranged 17–120 days (mean 40.5 ± 5.0) in the hybrid operation, with a success revascularization rate of 100%. All patients had thrombi extracted with the clot length ranging 5–8 cm (mean 6.3 ± 0.9). The thrombolysis in cerebral infarction grade (TICI) was significantly (
P
< 0.0001) greater immediately after (median 2,) than before recanalization (0). Periprocedural complications included recurrent laryngeal nerve injury in one patient and intracranial hemorrhage in another (6.7%), but no severe neurological deficits occurred. The symptoms were significantly (
P
< 0.0001) improved after compared with before operation, with the modified Rankin score of 2.5 ± 0.6 at 3 months postoperation which was significantly (
P
< 0.0001) improved compared with before revascularization (3.4 ± 0.6). Follow-up angiography revealed patent ICA in all patients with hybrid operation. In the medication alone group, no significant (
P
> 0.05) improvement was observed with the mRS score of 3.5 ± 0.8 at admission and 3.4 ± 0.7 at 3 months, which was significantly (
P
< 0.001) greater than in the hybrid operation.
Conclusion
Hybrid operation may be safe and effective in revascularizing long-segment occlusion of internal carotid artery for prevention of further ischemic events.</description><identifier>ISSN: 0028-3940</identifier><identifier>EISSN: 1432-1920</identifier><identifier>DOI: 10.1007/s00234-018-2145-7</identifier><identifier>PMID: 30552444</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Angiography ; Carotid arteries ; Carotid artery ; Cerebral blood flow ; Cerebral infarction ; Complications ; Data processing ; Drugs ; Hemorrhage ; Imaging ; Infarction ; Interventional Neuroradiology ; Ischemia ; Medicine ; Medicine & Public Health ; Neurological diseases ; Neurology ; Neuroradiology ; Neurosciences ; Neurosurgery ; Occlusion ; Patients ; Radiology ; Stents ; Thrombolysis</subject><ispartof>Neuroradiology, 2019-02, Vol.61 (2), p.217-224</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2018</rights><rights>Neuroradiology is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-650393cc02ecf9c84e6c23996fc4b8c88f02e09d2c0c8963777740668f5b4a303</citedby><cites>FETCH-LOGICAL-c372t-650393cc02ecf9c84e6c23996fc4b8c88f02e09d2c0c8963777740668f5b4a303</cites><orcidid>0000-0003-4668-0737</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30552444$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhang, Kun</creatorcontrib><creatorcontrib>Gao, Bu-Lang</creatorcontrib><creatorcontrib>Zhao, Tong-Yuan</creatorcontrib><creatorcontrib>Li, Tian-Xiao</creatorcontrib><creatorcontrib>Xue, Jiang-Yu</creatorcontrib><creatorcontrib>He, Ying-Kun</creatorcontrib><creatorcontrib>Cai, Dong-Yang</creatorcontrib><creatorcontrib>Yang, Bo-Wen</creatorcontrib><title>Hybrid operation to revascularize long-segment occluded internal carotid artery prevent further ischemic events</title><title>Neuroradiology</title><addtitle>Neuroradiology</addtitle><addtitle>Neuroradiology</addtitle><description>Purpose
The effects and complications of hybrid procedure (combined carotid endarterectomy and carotid stenting) to revascularize chronic long-segment occlusion of internal carotid artery (ICA) are currently unknown and the purpose of this study.
Methods
Sixty-five patients with long-segment occlusion of ICA were prospectively enrolled and divided into two groups of revascularization with hybrid operation (
n
= 30) and medication group (
n
= 35), and clinical and angiographic data were analyzed.
Results
The duration from symptom onset to revascularization ranged 17–120 days (mean 40.5 ± 5.0) in the hybrid operation, with a success revascularization rate of 100%. All patients had thrombi extracted with the clot length ranging 5–8 cm (mean 6.3 ± 0.9). The thrombolysis in cerebral infarction grade (TICI) was significantly (
P
< 0.0001) greater immediately after (median 2,) than before recanalization (0). Periprocedural complications included recurrent laryngeal nerve injury in one patient and intracranial hemorrhage in another (6.7%), but no severe neurological deficits occurred. The symptoms were significantly (
P
< 0.0001) improved after compared with before operation, with the modified Rankin score of 2.5 ± 0.6 at 3 months postoperation which was significantly (
P
< 0.0001) improved compared with before revascularization (3.4 ± 0.6). Follow-up angiography revealed patent ICA in all patients with hybrid operation. In the medication alone group, no significant (
P
> 0.05) improvement was observed with the mRS score of 3.5 ± 0.8 at admission and 3.4 ± 0.7 at 3 months, which was significantly (
P
< 0.001) greater than in the hybrid operation.
Conclusion
Hybrid operation may be safe and effective in revascularizing long-segment occlusion of internal carotid artery for prevention of further ischemic events.</description><subject>Angiography</subject><subject>Carotid arteries</subject><subject>Carotid artery</subject><subject>Cerebral blood flow</subject><subject>Cerebral infarction</subject><subject>Complications</subject><subject>Data processing</subject><subject>Drugs</subject><subject>Hemorrhage</subject><subject>Imaging</subject><subject>Infarction</subject><subject>Interventional Neuroradiology</subject><subject>Ischemia</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neurological diseases</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Neurosurgery</subject><subject>Occlusion</subject><subject>Patients</subject><subject>Radiology</subject><subject>Stents</subject><subject>Thrombolysis</subject><issn>0028-3940</issn><issn>1432-1920</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp1kUtv1DAUhS1ERYfCD2CDLLFhY3r9iGMvUQUUqRKbdm15bm6mqZJ4sBOk4dfj6RSQkPDG0j3fOX4cxt5I-CAB2ssCoLQRIJ1Q0jSifcY20mglpFfwnG2q7IT2Bs7Zy1IeAEC3un3BzjU0jTLGbFi6Pmzz0PG0pxyXIc18STzTj1hwHWMefhIf07wThXYTzQtPiOPaUceHeaE8x5FjzGmpCTHXwYHvq_kI9mte7inzoeA9TQPyx3F5xc76OBZ6_bRfsLvPn26vrsXNty9frz7eCNStWoRtQHuNCIqw9-gMWVTae9uj2Tp0rq8K-E4hoPNWt3UZsNb1zdZEDfqCvT_l7nP6vlJZwlRvQuMYZ0prCUo2rbXWG1XRd_-gD2k9Pu2RsspZ0-hKyROFOZWSqQ_7PEwxH4KEcGwjnNoItY1wbCO01fP2KXndTtT9cfz-_gqoE1CqNO8o_z36_6m_AI9dlcs</recordid><startdate>20190201</startdate><enddate>20190201</enddate><creator>Zhang, Kun</creator><creator>Gao, Bu-Lang</creator><creator>Zhao, Tong-Yuan</creator><creator>Li, Tian-Xiao</creator><creator>Xue, Jiang-Yu</creator><creator>He, Ying-Kun</creator><creator>Cai, Dong-Yang</creator><creator>Yang, Bo-Wen</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TK</scope><scope>7U7</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4668-0737</orcidid></search><sort><creationdate>20190201</creationdate><title>Hybrid operation to revascularize long-segment occluded internal carotid artery prevent further ischemic events</title><author>Zhang, Kun ; Gao, Bu-Lang ; Zhao, Tong-Yuan ; Li, Tian-Xiao ; Xue, Jiang-Yu ; He, Ying-Kun ; Cai, Dong-Yang ; Yang, Bo-Wen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-650393cc02ecf9c84e6c23996fc4b8c88f02e09d2c0c8963777740668f5b4a303</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Angiography</topic><topic>Carotid arteries</topic><topic>Carotid artery</topic><topic>Cerebral blood flow</topic><topic>Cerebral infarction</topic><topic>Complications</topic><topic>Data processing</topic><topic>Drugs</topic><topic>Hemorrhage</topic><topic>Imaging</topic><topic>Infarction</topic><topic>Interventional Neuroradiology</topic><topic>Ischemia</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neurological diseases</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosciences</topic><topic>Neurosurgery</topic><topic>Occlusion</topic><topic>Patients</topic><topic>Radiology</topic><topic>Stents</topic><topic>Thrombolysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhang, Kun</creatorcontrib><creatorcontrib>Gao, Bu-Lang</creatorcontrib><creatorcontrib>Zhao, Tong-Yuan</creatorcontrib><creatorcontrib>Li, Tian-Xiao</creatorcontrib><creatorcontrib>Xue, Jiang-Yu</creatorcontrib><creatorcontrib>He, Ying-Kun</creatorcontrib><creatorcontrib>Cai, Dong-Yang</creatorcontrib><creatorcontrib>Yang, Bo-Wen</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology 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Database</collection><collection>ProQuest_Research Library</collection><collection>ProQuest Biological Science Journals</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest advanced technologies & aerospace journals</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Neuroradiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhang, Kun</au><au>Gao, Bu-Lang</au><au>Zhao, Tong-Yuan</au><au>Li, Tian-Xiao</au><au>Xue, Jiang-Yu</au><au>He, Ying-Kun</au><au>Cai, Dong-Yang</au><au>Yang, Bo-Wen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hybrid operation to revascularize long-segment occluded internal carotid artery prevent further ischemic events</atitle><jtitle>Neuroradiology</jtitle><stitle>Neuroradiology</stitle><addtitle>Neuroradiology</addtitle><date>2019-02-01</date><risdate>2019</risdate><volume>61</volume><issue>2</issue><spage>217</spage><epage>224</epage><pages>217-224</pages><issn>0028-3940</issn><eissn>1432-1920</eissn><abstract>Purpose
The effects and complications of hybrid procedure (combined carotid endarterectomy and carotid stenting) to revascularize chronic long-segment occlusion of internal carotid artery (ICA) are currently unknown and the purpose of this study.
Methods
Sixty-five patients with long-segment occlusion of ICA were prospectively enrolled and divided into two groups of revascularization with hybrid operation (
n
= 30) and medication group (
n
= 35), and clinical and angiographic data were analyzed.
Results
The duration from symptom onset to revascularization ranged 17–120 days (mean 40.5 ± 5.0) in the hybrid operation, with a success revascularization rate of 100%. All patients had thrombi extracted with the clot length ranging 5–8 cm (mean 6.3 ± 0.9). The thrombolysis in cerebral infarction grade (TICI) was significantly (
P
< 0.0001) greater immediately after (median 2,) than before recanalization (0). Periprocedural complications included recurrent laryngeal nerve injury in one patient and intracranial hemorrhage in another (6.7%), but no severe neurological deficits occurred. The symptoms were significantly (
P
< 0.0001) improved after compared with before operation, with the modified Rankin score of 2.5 ± 0.6 at 3 months postoperation which was significantly (
P
< 0.0001) improved compared with before revascularization (3.4 ± 0.6). Follow-up angiography revealed patent ICA in all patients with hybrid operation. In the medication alone group, no significant (
P
> 0.05) improvement was observed with the mRS score of 3.5 ± 0.8 at admission and 3.4 ± 0.7 at 3 months, which was significantly (
P
< 0.001) greater than in the hybrid operation.
Conclusion
Hybrid operation may be safe and effective in revascularizing long-segment occlusion of internal carotid artery for prevention of further ischemic events.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>30552444</pmid><doi>10.1007/s00234-018-2145-7</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-4668-0737</orcidid></addata></record> |
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| language | eng |
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| source | Springer Link |
| subjects | Angiography Carotid arteries Carotid artery Cerebral blood flow Cerebral infarction Complications Data processing Drugs Hemorrhage Imaging Infarction Interventional Neuroradiology Ischemia Medicine Medicine & Public Health Neurological diseases Neurology Neuroradiology Neurosciences Neurosurgery Occlusion Patients Radiology Stents Thrombolysis |
| title | Hybrid operation to revascularize long-segment occluded internal carotid artery prevent further ischemic events |
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