Predicting procedure successful rate and 1-year patency after endovascular recanalization for chronic carotid artery occlusion by CT angiography

Abstract

Background: Proper patient selection criteria for treatment of carotid chronic total occlusion (CTO) are unclear. This study was designed to predict procedure successful rate and 1-year patency after carotid artery stenting (CAS) for carotid CTO using pre-procedural CTA.

Methods: Patients with CTO detected on CTA who underwent recanalization within 3months were divided into those with occlusions at (or distal to) the clinoid segment of the internal carotid artery (group A) and those with occlusions proximal to the clinoid segment (group B) and outcomes were compared between groups.

Results: Technical success rates, major complications, and re-occlusions within 1-year were 52%, 22%, 91% in group A (N=23), and 89%, 0%, 0% in group B (N=19), respectively. Diabetes was more frequent in group A (43%) compared with group B (11%).

Conclusion: CTA may play a role in predicting successful rate and 1-year patency for endovascular recanalization in carotid CTO.

Keywords: CT angiography; Carotid artery stenting; Chronic carotid artery occlusion; Chronic total occlusion; Endovascular recanalization.