Internal Carotid Artery Stenting in Patients with Near Occlusion: 30-Day and Long-Term Outcome

Article Figures & Data

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Fig 1.
NO of the left ICA. A, Reduced ICA diameter compared with the external carotid artery. Retrograde filling of the supraclinoid segment through the ophthalmic artery. B, Multichanneled NO of the ICA. C, ICA angiogram after stent placement.
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Fig 2.
Right ICA NO with a string sign. A, Lateral angiogram shows occlusion of the proximal ICA. B, Selective stump ICA injection shows the collapsed lumen of the ICA. C, Narrow stream of contrast progressing through the ICA in the late arterial phase. D, ICA angiogram after stent placement.
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Fig 3.
NO of the right ICA. A, Anteroposterior left carotid angiogram. Cross-filling of the contralateral anterior circulation via the AcomA. B, Anteroposterior left vertebral angiogram. Cross-filling of the right anterior circulation via the PcomA. C, Lateral right common carotid angiogram with NO. D, Lateral right carotid angiogram shows a filling delay of the intracranial ICA. Abrupt dilution of contrast in the supraclinoid ICA. E, Severe intimal dissection after predilation. F, Lateral angiogram after stent placement. G, Recovery of normal flow to the middle cerebral artery after stent placement in the NO.

Table 1:

Patient baseline characteristics

Characteristic	No. (%)
Patients	116 (100.0)
Men	99 (85.3)
Women	17 (14.7)
Mean age (range) (yr)	65.8 (40–82)
Symptomatic patients	105 (90.5)
TIA/amaurosis fugax	44 (37.9)
Minor stroke/stroke (mRS, <3)	61 (52.6)
Asymptomatic patients	11 (9.5)
Vascular risk factors
Diabetes	49 (42.2)
Hypertension	84 (72.4)
Hyperlipidemia	65 (56)
Cigarette smoking	56 (48.3)
Coronary artery disease	35 (30.2)
Peripheral vascular disease	27 (23.3)

Table 2:

Angiography findings

Findings	No. (%)
Left ICA NO	60 (51.7)
Right ICA NO	56 (48.3)
String sign	34 (29.3)
Decreased diameter of the ipsilateral ICA	82 (70.7)
Delayed arrival of contrast	116 (100)
Ulceration	58 (50)
Calcification	69 (59.6)
Intracranial lesion	12 (10.3)
Contralateral stenosis (%)
70–99	27 (23.3)
100	8 (6.9)
Collateral pathways
Patent AcomA	103 (88.8)
Patent PcomA	64 (55.2)
Ophthalmic artery	44 (37.9)
Leptomeningeal artery	29 (25)
Residual stenosis
0%	95 (81.9)
1–30%	14 (12.1)
31–50%	5 (4.3)
51–70%	2 (1.7)