Carotid Artery Stenting in Patients With Chronic Internal Carotid Artery Occlusion

Abstract

Retrospective, single-center review between January 1, 2010 and July 1, 2020. Of 27 patients who had symptoms within the past 6 months (16 ipsilateral stroke, 6 chronic cerebral hypoperfusion, 2 transient ischemic attacks [TIAs], 2 chronic ocular ischemia, 1 amaurosis fugax), technical success deploying internal carotid artery (ICA) stents via a transfemoral approach (TF-CAS) was achieved in about half (14) of the cases. One patient developed a minor reversible stroke (3.7%) and there were no early deaths. Two patients had perioperative TIAs. During follow-up (mean, 2.4 years) of 14 patients with successful CAS, one had minor, reversible ipsilateral stroke and two had contralateral strokes Among 13 patients with unsuccessful CAS, 31% (4) suffered stroke during follow-up. TF-CAS of symptomatic patients with chronic ICA occlusion was feasible in half the patients with no mortality or major stroke. Since one-third of patients with unsuccessful stenting developed stroke during follow-up, further studies to investigate the safety, efficacy, and durability of CAS for chronically occluded ICAs are needed.