Interventional Treatment for Internal Carotid Artery Near-Occlusion with Different Distal Vessel Diameters.

Objective: To investigate the efficacy and safety of endovascular treatment in patients with internal carotid artery near-occlusion accompanied by a distal vessel diameter of ≤2 mm.

Methods: Sixty-six patients who underwent endovascular treatment for internal carotid artery near-occlusion at the Fourth Affiliated Hospital of Guangzhou Medical University and Guangdong Provincial Hospital of Traditional Chinese Medicine between February 2018 and November 2023 were divided into a full collapse group (distal vessel diameter ≤2 mm, n=28) and a non-full collapse group (distal vessel diameter >2 mm, n=38). All patients received dual antiplatelet therapy before the procedure. Protection with a protective umbrella or thrombectomy stent was used during surgery according to the lesion characteristics.

Results: Baseline characteristics were comparable between the two groups. The endovascular treatment success rate was 100% in both groups. There was no significant between-group difference regarding the use of small balloon predilation. The incidence of perioperative adverse events (such as ipsilateral stroke, hyperperfusion, hypotension, and myocardial infarction) was comparable in the two groups (21.43% and 21.05%, respectively; p>0.05). At the 12-month follow-up, the full collapse group had a higher incidence of ipsilateral stroke (7.14% vs 2.63%), but the difference was not statistically significant. There was one case of restenosis in both groups.

Conclusion: Our findings demonstrate the safety and effectiveness of endovascular treatment for patients with internal carotid artery near-occlusion with different distal vessel diameters.