Balloon guide catheter in recanalization of intracranial internal carotid artery occlusion

Abstract

Objective To evaluate the safety and feasibility of balloon guide catheter (BGC) in recanalization of intracranial internal carotid artery occlusion. Methods Retrospective analysis was conducted in 7 patients with non-acute symptomatic intracranial internal carotid artery occlusion who underwent endovascular revascularization under the protection of BGC in our hospital from March 2016 to August 2016. The duration of occlusion ranged from 3 weeks to one year with mean time of 22 weeks. The technical aspects of using BGC were analyzed. Results Recanalization was successful in all 7 patients with an overall technical success rate of 100%, and the residual stenosis rate was<70%. The duration time from the beginning of the first BGC filled to the end of BGC released after successfully implanted of the stent ranged from 8 minutes to 50 minutes, averaged 18.6 minutes. Among them, 6 were less than 20 min; and one was 50 min, mainly because of the difficulty of micro guide wire passing through the occlusion. There was no procedural visible vascular embolization or perioperative new cerebral ischemic event, and one patient developed symptomatic cerebral hemorrhage that healed completely without any neural function loss. The patients were followed-up from one to 3 months after operation, no new cerebral ischemic event was observed, and both the improvement rate of symptoms and the patency rate were 100% (7 of 7) in the follow-up period. Conclusion Endovascular revascularization under the protection of BGC is feasible and safe in the treatment of patients with non-acute intracranial internal carotid artery occlusion, but further investigation about patient screening, timing of surgery, recanalizing technique and postoperative management is necessary. Key words: Internal carotid artery; Arterial occlusion disease; Endovascular treatment; Recanalization; Balloon guide catheter