Soonchan Park MD, Presenter: Nothing to Disclose

Deok Hee Lee, Abstract Co-Author: Nothing to Disclose

Choong Gon Choi MD, Abstract Co-Author: Nothing to Disclose

Sang Joon Kim MD, Abstract Co-Author: Nothing to Disclose

Dae Chul Suh, Abstract Co-Author: Nothing to Disclose

To report our experience of endovascular treatment results of acute long segmental internal carotid artery (ICA) thrombotic occlusion secondary to distal ICA stenosis.

From March 2008 to December 2010, we retrospectively analyzed the endovascular treatment results of 14 cases of acute long segmental ICA thrombotic occlusion caused by underlying distal ICA stenosis. There were 6 male and 8 female patients with a mean age of 63.2 ( range, 51- 83 years). Clinical status such as NIHSS, underlying medical conditions was collected. Occlusion lengths, sites, type and number of stents along with the use of thrombectomy, ballooning angioplasty and concomitant thrombolytics were also collected. We investigated the recanalization rate immediately after the stent placement, additional procedures, occurrence of postprocedural complications.

All patients had underlying atherosclerotic stenosis which led to proximal long segmental thrombotic occlusion . Underlying medical conditions were hypertension (9 patients), DM (7 patients) and hyperlipidemia (6 patients). An initial mean NIHSS was 7.1 (range, 4-14). A postprocedural mean NIHSS was 5 (range, 0-11) . Mean occlusion length was 10.6 cm (range, 4.7-15.2 cm). Underlying stenotic sites were anterior genu (6 cases), posterior genu (2 cases), horizontal portion (2 cases) of cavernous ICA, petrocavernous junction (1 case) and terminal segment of ICA (3 cases). 6 balloon expandable stents and 11 self expandable stents were used with a mean number of 1.5 stents a patient. Concomitant sunction thrombectomy (10 cases), balloon angioplasty (9 cases) and IV thrombolytics (6 cases) were used. Immediate recanalization was 78.5 % (11 out of 14) . Postprocedural imaging revealed evolution of previous infarctions (7 cases), small embolic infarctions (2 cases), and no change of previous infarctions (3 cases).

Endovascular revascularization of acute long segmental ICA thrombotic occlusion secondary to distal ICA stenosis is feasible and can improve clinical outcome. Reocclusion can be managed follow-up procedures such as balloon angioplasty or additional stenting.

Aucte long segmental ICA thrombotic occlusion could be managed with endovascular methods with improved clinical outcome and restenosis could be further treated with another endovascular access.

Park, S, Lee, D, Choi, C, Kim, S, Suh, D, Endovascular Revascularization of Acute Long Segmental Internal Carotid Artery Thrombotic Occlusion Secondary to Distal Internal Carotid Artery Stenosis.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11034477.html