Analysis Of Recanalization For 11 Patients With Head And Neck Arterial Occlusion

Chronic head and neck arterial occlusion is one of the important causes of ischemic stroke,resulting in 15%-25% of ischemic stroke,even in the case of the best drug treatment program,the risk of blood vessels within 2 years of ischemic stroke can still reach 10%-15%.Treatment of head and neck arterial occlusion is currently a worldwide problem,drug therapy including anti-platelet aggregation,anticoagulant,decrease blood lipids,control blood pressure,etc.Surgical recanalization includes carotid endarterectomy and extracranial-intracranial(EC-IC)bypass surgery.In recent years,with the development of nerve intervention materials and imaging,endovascular recanalization and hybrid surgery have been developed in clinical.However,there is controversy in the surgical treatment for patients with symptomatic head and neck arterial occlusion.Some scholars believe that the head and neck arterial occlusion in patients with surgical technique is difficult,postoperative complications,high risk,is not recommended to recanalization.Another part of the scholars believe that in cases of strict screening cases,the implementation of CEA in patients with carotid artery occlusion is safe,which can get a good mid-term patency rate and recovery of neurological function and improve cerebral blood supply.Objective:To study the indications of recanalization of head and neck arterial occlusion,to explore the complications and preventive measures.Methods:The clinical data,surgical complications and follow-up data of 11 patients with head and neck arterial occlusion were collected from January 2015 to December 2016 in the Jilin university affiliated second hospital,and analyzed with relevant literature.Results:There were 7 males(63.6%)and 4 females(36.4%).Aged 50 to 75 years,an average of 61.4 years old.The main clinical symptoms of dizziness were found in 2 cases,4 cases of side of the limb movement disorders,speech disorders with side of the limb activity is not working in 2 cases,as unclear 2 cases,a lack of awareness of 1 case.Patients were examined by head and neck angiography(including CTA,MRA,vascular ultrasound)within 1 to 3 days after admission.Among them,bilateral ICA occlusion in 1 case(9.1%),left ICA occlusion in 6 cases(54.5%),left ICA with right CCA occlusion in 1 case(9.1%),unilateral VA occlusion in 2 cases(18.2%).Surgical approach: intravascular treatment in 8 cases(72.7%)and hybrid surgery in 3 cases(27.3%).Postoperative efficacy was assessed using the modified Rankin scale.There were 3 patients with 1 point(27.3%),2 patients with 1 point(18.2%),3 patients for 2 points(27.3%),2 patients for 3 points(18.2%).There were 1 case(9.1%).Conclusion:1.Endovascular recanalization and hybrid surgery for the treatment of head and neck artery occlusion is technically feasible 2.Endovascular recanalization and hybrid surgery can effectively improve neurological dysfunction.