Effect of endovascular treatment on high-risk patients with chronic carotid artery occlusion.

OBJECTIVE: This study aims to discuss the safety and short-term efficacy of endovascular treatment on high-risk patients with chronic carotid artery occlusion. METHODS: A retrospective analysis was performed on the clinical data of 16 high-risk patients with chronic carotid artery occlusion who received endovascular treatment at the Department of Neurosurgery of the First Affiliated Hospital of Xinjiang Medical University from November 2013 to July 2016. The incidence of adverse events at 1 week, 30 days and six months post-operation were observed, and NIHSS was adopted to assess the neurological function of patients six months before and after the operation. Follow-up time was 6-26 months, with an average of 18.4 months. RESULTS: The degree of carotid artery stenosis of these 16 patients was 100%. The degree of which after the operation was 24.9 ± 17.0%; and the difference was statistically significant (P<0.05). Iatrogenic carotid artery dissection occurred in one case, and persistent hypotension and sinus bradycardia occurred in one case. Furthermore, one case of endovascular treatment was not approved to be opened. Afterwards, temporal artery-STA-MCA bypass was performed; upon postoperative head CTA and DSA, the result showed that the perfusion was good. One case refused to undergo surgical treatment. The NHSS score of 14 cases of endovascular treatment that were successfully opened six months after the operation was 2.0 ± 1.36, which improved (P<0.05) compared with that of pre-operation. CONCLUSION: Endovascular treatment on high-risk patients with chronic carotid artery occlusion is safe and effective. And it has obvious curative effect in short mid-term. KEY WORDS: Arterial occlusive disease, Carotid artery, Endovascular treatment, Treatment outcome.

Operative managements of extracranial carotid artery aneurysms: a report of three cases and literature review.

BACKGROUND: The purpose of this study is to report the treatment approaches and postoperative outcomes of extracranial carotid artery aneurysms (ECAAs) and discuss the symptoms, related risk factors, etiology, diagnostic methods, treatments, and follow-up period complications. CASE PRESENTATION: We describe three patients with symptomatic extracranial carotid artery aneurysms; one of them was treated with end-to-end anastomosis of the extracranial internal carotid artery (EICA) after the resection of the aneurysm, while the other two patients were deployed with Willis covered stents in the extracranial internal carotid artery. All of the patients were in good condition when discharged home. After a mean follow-up period of 8 months, all the patients were alive and only one of them had the neurologic deficit. Additionally, we reviewed the relative literatures. CONCLUSION: Both of the surgical and endovascular treatments have relatively satisfactory outcomes in ECAA patients. However, it is necessary to provide individualized treatments to different patients according to the characteristics of the aneurysms.