Safety And Efficacy Of Hybrid Surgery For Symptomatic Chronic Internal Carotid Artery Occlusion

Objective: The clinical optimal treatment for Patients with symptomatic chronic internal carotid artery occlusion remains inconclusive.Therefore,to explore the safety and efficacy of combined surgical treatment of symptomatic chronic internal carotid artery complete occlusion.Methods: The clinical data,imaging and follow-up data of 27 patients with symptomatic CICAO who underwent hybrid surgery at Neurosurgery Center of the First Affiliated Hospital of Xinjiang Medical University from May 2020 to May 2022 were retrospectively analyzed.Patients were divided into groups according to the data:(1)According to the length of the block segment,they were divided into group A and below(C1-C3)block;Group B internal carotid artery occlusion above the petro-bone segment(C4-C7).(2)Statistical analysis was conducted according to the occlusion site,whether there was ophthalmoarterial compensation,the success rate of recanalization,and m RS Scores before and 6 months after surgery.The general condition,success rate of surgical recanalization,perioperative complications and long-term complications,and m RS Scale score before and 6 months after operation were recorded for analysis.Results: 1.A total of27 Patients with symptomatic CICAO treated with hybrid surgery were included in the study.11 patients in group A and 16 patients in group B were blocked.In group A,9patients succeeded in recanalization and 2 failed,and in group B,13 patients succeeded in recanalization and 3 failed.The success rate of recanalization in group A was higher than that in group B,and the difference was not statistically significant.2.According to the main clinical symptoms,the patients were divided into groups:(1)TIA group: 18 cases,stroke group: 9 cases;(2)DSA classification: type A 19 cases,recanalization failure in 3cases;Type B in 9 cases,failure in 1 case;Type C in 2 cases,failure in 1 case;0 cases of type D;There was no significant difference among all groups(P=0.598).3.Improved m RS Scores before and 6 months after surgery: after 6 months of follow-up,the m RS Score was significantly reduced and the neurological function of the patients improved,with statistical significance between the two groups(P=0.005).Conclusion: 1.For patients with symptomatic chronic internal carotid artery occlusion after strict screening,the hybrid surgery is technically feasible,the surgical safety is guaranteed,and the technical success rate is high;2.In this study,it was found that the success rate of surgery was higher in patients with ophthalmic artery reflux to the intracranial than in patients without ophthalmic artery reflux,and hybrid surgery could reduce the risk of postoperative stroke in patients.