Surgical embolectomy for internal carotid artery terminus occlusion.

Abstract

The aim of this study was to assess the efficacy and safety of surgical embolectomy for internal carotid artery terminus (ICA-T) occlusion. Twenty-five consecutive patients with acute ischemic stroke attributed to embolic ICA-T occlusion who underwent surgical embolectomy were retrospectively reviewed. Twenty-four patients were examined based on magnetic resonance imaging, with one patient included based on a computed tomography scan. Recanalization rate, recanalization time, complications, National Institutes of Health Stroke Scale (NIHSS) score improvement at 1month, and modified Rankin Scale (mRS) at 3months were evaluated. Final recanalization status was Thrombolysis in Myocardial Infarction (TIMI) 3 in 24 patients (96%). Median recanalization time from symptom onset and from start of surgery was 281 and 79min, respectively. Two patients (8%) had major hemorrhagic complications related to surgery. Seventeen patients (68%) demonstrated NIHSS score improvement of more than 10 points at 1month. At 3months, eight patients (32%) were mRS 0-2, five patients (20%) were mRS 3, and three patients (12%) had died. Surgical embolectomy for ICA-T occlusion demonstrated a high complete recanalization rate and should be reconsidered as an additional therapeutic strategy to overcome this devastating situation.