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Endovascular Treatment for Near Occlusion of the Internal Carotid Artery

30-Day Outcome and Long-Term Follow-Up

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Abstract

Background

The treatment strategy and the correct incidence of near occlusion (NO) of the internal carotid artery (ICA) is still controversial. In routine radiological imaging NO can easily be misdiagnosed as complete occlusion and there is no consensus on the standard treatment strategy.

Purpose

To present our perioperative and long-term follow-up results of ICA NO patients treated with carotid artery stenting (CAS).

Material and Methods

Between 2004–2014 a total of 182 patients with ICA NO were evaluated for CAS. The study included 132 male (72.5 %) and 50 female (27.5 %) patients with a mean age of 70.2 years. Patients underwent a clinical neurological evaluation and radiological imaging of the carotid arteries before the CAS procedure. Of the patients 80 (44 %) were asymptomatic. The median clinical and carotid Doppler ultrasound (DUS) follow-up period was 64 months (range 18–124 months).

Results

In 182 patients CAS were performed, 4 patients (2.2 %) developed minor stroke, 2 patients (1.1 %) developed myocardial infarction but no major stroke or death occurred in the following 30-day period. Asymptomatic restenosis was detected in seven patients (3.8 %) in the follow-up period.

Conclusion

With sufficient neurological evaluation during pretreatment and posttreatment periods and when the procedure is performed with technologically developed products by an experienced interventional team, CAS is beneficial in patients with ICA NO.

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Authors and Affiliations

  1. Department of Radiology, Gazi University School of Medicine, 06510, Besevler/Ankara, Turkey

    Koray Akkan, Erhan Ilgit, Baran Onal, Emetullah Cindil, Evsen Polattas Solak, Fatih Oncu & Dilan Ece Geylan

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  1. Koray Akkan
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  2. Erhan Ilgit
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Correspondence to Koray Akkan.

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Conflict of Interests

K. Akkan, E. Ilgit, B. Onal, E. Cindil, E.P. Solak, F. Oncu and D.E. Geylan declare that they have no competing interests.

Ethical standards

All studies described in this manuscript were carried out in accordance with national law and the Helsinki Declaration from 1975 (in its current revised form). Informed consent was obtained from all individual participants included in the study and those identifiable from images or other information within the manuscript.

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Akkan, K., Ilgit, E., Onal, B. et al. Endovascular Treatment for Near Occlusion of the Internal Carotid Artery. Clin Neuroradiol 28, 245–252 (2018). https://doi.org/10.1007/s00062-016-0546-8

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