Article Figures & Data
Figures
- Fig 1.
Recanalization procedure schematic. A, The procedure is initiated with proximal protection with the occlusion balloon at the CCA and the ECA. B, The aspiration catheter is navigated along the guidewire, which is passed successfully across the occluded segment under proximal protection. C, The distal protection balloon is navigated beyond the occluded segment through the extraction port of the aspiration catheter. D, The occluded segment is dilated with the balloon under distal protection. E, The ICA is recanalized after the stents are deployed and the thrombi are aspirated.
- Fig 2.
Successful recanalization of a left chronic ICA occlusion (case 4). A 78-year-old man with recurrent episodes of transient right hemiparesis underwent recanalization at 6 months after the initial diagnosis of left ICA occlusion. A–C, Lateral projections of the left carotid angiogram. A, Before treatment, the occlusive lesion extends from the cervical segment to the petrous segment of the ICA. B, Just after the recanalization. C, One-year follow-up. D, DWI obtained 1 day after the procedure. Asymptomatic small ischemic lesions ≤9 mm are detected in the ipsilateral side of the recanalized ICA and in the contralateral side. E and F, SPECT images with acetazolamide vasodilatory challenge before and 13 months after the procedure, respectively. Severe impairment of the left cerebral hemispheric vascular reserve improved after successful recanalization of the ipsilateral ICA.
- Fig 3.
Successful recanalization of right chronic ICA occlusion (case 5). A 69-year-old man with a minor completed stroke in the right parietal lobe underwent recanalization at 7 months after the initial diagnosis of right ICA occlusion. A–C, Lateral projections of the right carotid angiogram. A, Before treatment, the occlusive lesion extends from the cervical segment to the cavernous segment of the ICA. B, Just after the recanalization. C, Sagittal reconstruction of 3D-CTA obtained 4 months after the procedure shows no restenosis along the recanalized ICA. D, DWI obtained 1 day after the procedure. Small asymptomatic ischemic lesions are detected in the ipsilateral cerebral hemisphere. E and F, SPECT images with acetazolamide vasodilatory challenge before and 6 months after the procedure, respectively. Severe impairment of the vascular reserve of the right cerebral hemisphere improved after successful recanalization of the right ICA.
Tables
Initial and follow-up results
Case No. Initial Results Follow-Up Results Recanalized DW Complication Period (mo) Ischemic Events and Complication Patency 1 Yes 4 None 32 None Patent at 1 year (CA) 2 Yes 11 None 26 None Patent at 1 year (CA) 3 Yes 0 None 22 None Patent at 1 year (CTA) 4 Yes 14 None 20 Retinal hemorrhage Patent at 1 year (CA) 5 Yes 5 None 18 None Patent at 1 year (CA) 6 No 2 None 14 None Not recanalized 7 Yes 3 Groin hematoma 14 None Reoccluded 2 months after 1st procedure (CTA) Patent 4 months after 2nd recanalization (CTA) 8 Yes 0 None 9 None Patent at 1 month (duplex sonography)
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