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Tytuł:
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Acute Endovascular Revascularization for Patients with Common Carotid Artery Occlusion Apparent on Cervical Magnetic Resonance Angiography.
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Autorzy:
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Asano H; Department of Neurosurgery Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan. Electronic address: .
Shimizu T; Department of Neurosurgery Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan. Electronic address: .
Aihara M; Department of Neurosurgery Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan. Electronic address: .
Yamaguchi R; Department of Neurosurgery Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan. Electronic address: .
Aishima K; Department of Neurosurgery Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan. Electronic address: .
Yoshimoto Y; Department of Neurosurgery Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan. Electronic address: .
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Źródło:
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Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [J Stroke Cerebrovasc Dis] 2021 Apr; Vol. 30 (4), pp. 105626. Date of Electronic Publication: 2021 Jan 27.
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Typ publikacji:
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Case Reports; Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: Philadelphia, PA : Saunders
Original Publication: New York, NY : Demos Publications, [1991-
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MeSH Terms:
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Cerebral Angiography*
Endovascular Procedures*/adverse effects
Magnetic Resonance Angiography*
Thrombectomy*/adverse effects
Carotid Artery, Common/*diagnostic imaging
Carotid Stenosis/*therapy
Aged ; Aged, 80 and over ; Carotid Artery, Common/physiopathology ; Carotid Stenosis/diagnostic imaging ; Carotid Stenosis/physiopathology ; Cerebrovascular Circulation ; Female ; Humans ; Male ; Predictive Value of Tests ; Retrospective Studies ; Suction ; Treatment Outcome
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Contributed Indexing:
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Keywords: Acute endovascular revascularization; Cerebral infarction; Cervical magnetic resonance angiography; Common carotid artery occlusion; Internal carotid artery occlusion
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Entry Date(s):
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Date Created: 20210130 Date Completed: 20210323 Latest Revision: 20210323
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Update Code:
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20240104
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DOI:
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10.1016/j.jstrokecerebrovasdis.2021.105626
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PMID:
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33516069
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Objectives: In the endovascular treatment of acute cerebral large-vessel occlusion, cervical magnetic resonance angiography (MRA) is a useful modality for assessing the access route. However, we sometimes encounter cases in which not only the internal carotid artery (ICA), but also the common carotid artery (CCA) is poorly visualized, leading to hesitation over which devices and techniques to choose for revascularization. We retrospectively evaluated such cases, focusing on image findings and treatment results.
Materials and Methods: Data from 96 patients who underwent acute endovascular revascularization from January 2016 to December 2019 were analyzed. We extracted patients with poor CCA visualization on cervical MRA from 35 cases with ICA occlusion, and examined angiographic findings, treatment methods, and outcomes.
Results: Poor visualization of the CCA in cervical MRA was observed in 8 cases. All cases displayed atrial fibrillation or sick sinus syndrome. Angiographic findings showed true CCA occlusion in 2 patients and ICA occlusion in 6 patients. Reasons for the inability to visualize the CCA on cervical MRA were speculated to be stenosis of the external carotid artery (ECA), presence of embolism in the ECA, or severe heart failure. In cases of true CCA occlusion, thrombus was aspirated using the balloon guide catheter and good recanalization was obtained. Seven of 8 patients displayed favorable recanalization, with good prognosis after 90 days in 5 patients.
Conclusions: Poor CCA visualization on cervical MRA does not necessarily represent true CCA occlusion. Aspiration of thrombus from a balloon guide catheter is effective for true CCA occlusion.
Competing Interests: Declaration of interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
