RT Journal Article
SR Electronic
T1 The Outcome and Efficacy of Recanalization in Patients with Acute Internal Carotid Artery Occlusion
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 747
OP 753
DO 10.3174/ajnr.A3747
VO 35
IS 4
A1 J.H. Kwak
A1 L. Zhao
A1 J.K. Kim
A1 S. Park
A1 D.-g. Lee
A1 J.H. Shim
A1 D.H. Lee
A1 J.S. Kim
A1 D.C. Suh
YR 2014
UL http://www.ajnr.org/content/35/4/747.abstract
AB BACKGROUND AND PURPOSE: Acute occlusion of the ICA is often associated with poor outcomes and severe neurologic deficits. This study was conducted to evaluate outcome of the occluded ICA and efficacy of recanalization under protective flow arrest. MATERIALS AND METHODS: Fifty consecutive patients who underwent endovascular treatment for acute ICA occlusion were identified from the prospectively collected data base. We assessed NIHSSo, occlusion type (cardioembolism vs atherosclerosis), occlusion level (supraclinoid-terminal, petrocavernous, or bulb-cervical), recanalization degree (TICI), and efficacy of recanalization (protective flow arrest vs nonprotection) leading to better outcome. RESULTS: Successful recanalization (TICI ≥ 2) was obtained in 90% of patients and good recovery (mRS ≤ 2) in 60% of patients. Good outcome was related to National Institutes of Health Stroke Scale score on admission (P < .001), TICI (P < .007), occlusion type (P = .022), and occlusion level (P = .038). Poor initial patient status, less recanalization, cardioembolism, and supraclinoid-terminal occlusion were associated with poor prognosis. Application of protective flow arrest led to better outcome in the distal ICA segment than in the bulb-cervical segment. CONCLUSIONS: In addition to the initial patient status and successful recanalization, the occlusion level or type of the occluded ICA could affect clinical outcome. In this study, treatment benefits of protective flow arrest were accentuated in patients with ICA occlusion above the bulb-cervical segment. ECICextracranial-intracranialIMS IIIInterventional Management of Stroke III trialNIHSSoNational Institutes of Health Stroke Scale score on admissionTOASTTrial of Org 10172 in Acute Stroke Treatment