• World Neurosurg · Jul 2022

    Carotid artery stenting for near occlusion with full collapse.

    • Koji Omoto, Katsutoshi Takayama, Kaoru Myouchin, Takeshi Wada, Ichiro Nakagawa, Toshihiro Tanaka, Shinichiro Kurokawa, Hiroyuki Nakase, and Kimihiko Kichikawa.
    • Department of Neurosurgery, Ishinkai Yao General Hospital, Yao, Osaka, Japan. Electronic address: koujiplain128@gmail.com.
    • World Neurosurg. 2022 Jul 1; 163: e215-e222.

    ObjectiveCarotid near occlusions show a lower risk of stroke than other types of severe stenosis. However, emerging evidence suggests that near occlusion with full collapse differs from that without full collapse. The results of treatment with carotid artery stenting for near occlusion with full collapse are presented.MethodsBetween March 2007 and December 2020, 18 of 477 carotid artery stenting procedures were performed in patients with near occlusion with full collapse (3.8%). A total of 17 men and one woman with a mean age of 76.1 years were included. Eleven patients (61%) were symptomatic. The technical success rate, incidence of symptomatic stroke within 30 days, new ipsilateral ischemic lesions on diffusion tensor imaging within 48 hours after carotid artery stenting, and follow-up results (ipsilateral stroke rate and restenosis rate) were retrospectively assessed.ResultsThe technical success rate was 100%. All carotid artery stenting procedures were performed using embolic protection devices. No symptomatic stroke occurred within 30 days. New ipsilateral ischemic lesions on magnetic resonance imaging were observed in 16.7% (3/18) of patients. Asymptomatic minor cerebral hemorrhage occurred in 2 patients (11.1%) with cerebral hyperperfusion syndrome. The median follow-up period was 77 months. Asymptomatic restenosis of 50% occurred in one patient (5.5%), and asymptomatic occlusion occurred in one patient (5.5%). During follow-up, no patients experienced ipsilateral stroke. Three patients (16.7%) died from nonneurological causes.ConclusionsCarotid artery stenting for near occlusion with full collapse seems to be a feasible and safe procedure that can be performed by an experienced neuro-interventional team.Copyright © 2022 Elsevier Inc. All rights reserved.

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