Hybrid Surgery for Revascularization of Chronic Occlusion of Internal Carotid Artery

Objective: The aim of this study was to conclude the safety and effectiveness of hybrid surgery for revascularization of chronic occlusion of internal carotid artery (COICA). Methods: A total of 56 COCIA patients underwent hybrid surgery (carotid endarterectomy+carotid artery stenting) from September 2017 to September 2021 in our department. The clinical material and radiology data (preoperation and postoperation) were retrospectively analyzed to conclude the safety and effectiveness of hybrid surgery for revascularization of COICA. Results: All 56 patients underwent hybrid surgery got revascularization successfully (with a successful rate of 100%) and improved intracranial blood flow. The computed tomography perfusion results indicate that the postoperative cerebral blood flow perfusion of the patient is significantly improved compared with before surgery. In 1 patient, postoperative brain magnetic resonance imaging within 24 hours showed spotted fresh infarction with head magnetic resonance imaging, without any clinical symptoms; 3 patients developing symptoms of ipsilateral neural-functional defect (hypoglossal nerve, superior laryngeal nerve, and mandibular branch of facial nerve, respectively), 2 weeks later the symptoms were disappeared. Imaging study at 3 and 6 months during the follow-up showed no abnormalities. Conclusion: Hybrid surgery is safe and effective for revascularization of COICA.