Hybrid surgery for chronic internal carotid artery occlusion

Objective To investigate the efficacy and safety of hybrid surgery on revascularization of chronic internal carotid artery occlusion. Methods and Results Eight cases of chronic internal carotid artery occlusion underwent hybrid surgery in our medical center during September 2017 to September 2018 were analyzed retrospectively. Assessment preoperative, surgical procedure, surgical complication and prognosis including clinical data, lab examination, imaging findings during the follow-up period were recorded. All 8 patients underwent hybrid surgery [carotid endarterectomy (CEA) + carotid arterystenting (CAS)]. The revascularization of 8 patients was successful. The intracranial blood flow improvement was confirmed by carotid artery ultrasound, transcranial Doppler (TCD), CTP or PWI and DSA. Brain MRI ofone patient within 24 h postoperation showed visible spotted fresh infarction with no clinical symptoms, and 3 patients occurred ipsilateral cranial nerve injury symptoms (hypoglossal nerve, superior laryngeal nerve and mandibular branch of facial nerve) at postoperation, which were recovered in 2 weeks. All patients had no postoperative cerebral hyperperfusion. Imaging study showed the revascularization was successful and intracranial perfusion was improved at 3 and 6 months during the follow-up. Conclusions Hybrid surgery (CEA + CAS) is safe and effective for carotid artery occlusion. DOI:10.3969/j.issn.1672-6731.2019.10.009