Interventional Treatment for Internal Carotid Artery Near-Occlusion with Different Distal Vessel Diameters.

Abstract

To investigate the efficacy and safety of endovascular treatment in patients with internal carotid artery near-occlusion accompanied by a distal vessel diameter of ≤2 mm. Sixty-six patients who underwent endovascular treatment for internal carotid artery near-occlusion at the Fourth Affiliated Hospital of Guangzhou Medical University and Guangdong Provincial Hospital of Traditional Chinese Medicine between February 2018 and November 2023 were divided into a full collapse group (distal vessel diameter ≤2 mm, n = 28) and a nonfull collapse group (distal vessel diameter >2 mm, n = 38). All patients received dual antiplatelet therapy before the procedure. Protection with a protective umbrella or thrombectomy stent was used during surgery according to the lesion characteristics. Baseline characteristics were comparable between the 2 groups. The endovascular treatment success rate was 100% in both groups. There was no significant between-group difference regarding the use of small balloon predilation. The incidence of perioperative adverse events (such as ipsilateral stroke, hyperperfusion, hypotension, and myocardial infarction) was comparable in the 2 groups (21.43% and 21.05%, respectively; P > 0.05). At the 12-month follow-up, the full collapse group had a higher incidence of ipsilateral stroke (7.14% vs. 2.63%), but the difference was not statistically significant. There was 1 case of restenosis in both groups. Our findings demonstrate the safety and effectiveness of endovascular treatment for patients with internal carotid artery near-occlusion with different distal vessel diameters.