HSIEN-LI KAOCHI-SHENG HUNGHUNG-YUAN LICHIH-FAN YEHCHING-CHANG HUANGYING-HSIEN CHENSUNG-CHUN TANGCHI-CHAO CHAOMAO-SHIN LIN2022-01-172022-01-172018-11-1500029149https://scholars.lib.ntu.edu.tw/handle/123456789/592619Successful carotid artery stenting may correct ipsilateral hemisphere hypoperfusion and improve neurocognitive function in patients with chronic internal carotid artery occlusion (ICAO). Its effect on long-term outcomes, however, has never been studied. From May 2004 to April 2015, endovascular recanalization for chronic ICAO was attempted in 118 consecutive patients (119 lesions; 98 men; 67 ± 10 years old) with either recurrent neurologic events or objectively impaired ipsilateral hemisphere perfusion. Technical success in recanalization was achieved in 70 lesions (59%, 70/119). 3-months cumulative any stroke or death rate was 5% (6/119; 4 in recanalized group, 2 in failure group), including 2 periprocedural ischemic stroke, 2 intracranial hemorrhage, and 2 subarachnoid hemorrhage. In recanalized patients without periprocedural complication, 1-year reocclusion rate was 15% (10/65). Up to 7 years after procedure, cumulative events of transient ischemic attack (TIA), or any stroke, or death were 17 in recanalized group, compared with 23 in failure group (hazard ratio 0.51, 95% confidence interval 0.27 to 0.97; p = 0.04). The difference became more significant after excluding patients with periprocedure events (hazard ratio 0.41, 95% confidence interval 0.20 to 0.84, p = 0.015). In conclusions, the technical success and periprocedural complication rates of endovascular recanalization for chronic ICAO were acceptable. The cumulative event rates of any stroke or death up to 7 years were more favorable in patients after successful recanalization, compared to those in patients after failed procedure.enSYMPTOMATIC PATIENTS; INTRACRANIAL BYPASS; STROKE RISK; IMPROVEMENT; PROGNOSIS; STENOSIS; SURGERY[SDGs]SDG3adult; aged; artery reocclusion; Article; brain hemorrhage; brain ischemia; brain perfusion; carotid artery obstruction; cerebrovascular accident; controlled study; coronary artery recanalization; endovascular surgery; female; hemisphere; human; major clinical study; male; mortality rate; neurologic disease; outcome assessment; priority journal; subarachnoid hemorrhage; transient ischemic attack; treatment failure; carotid artery obstruction; chronic disease; diagnostic imaging; duplex Doppler ultrasonography; endovascular surgery; follow up; incidence; internal carotid artery; magnetic resonance angiography; middle aged; postoperative complication; procedures; retrospective study; stent; survival rate; Taiwan; time factor; treatment outcome; trends; very elderly; x-ray computed tomography; Adult; Aged; Aged, 80 and over; Carotid Artery, Internal; Carotid Stenosis; Chronic Disease; Endovascular Procedures; Female; Follow-Up Studies; Humans; Incidence; Magnetic Resonance Angiography; Male; Middle Aged; Postoperative Complications; Retrospective Studies; Stents; Survival Rate; Taiwan; Time Factors; Tomography, X-Ray Computed; Treatment Outcome; Ultrasonography, Doppler, Duplexjournal article10.1016/j.amjcard.2018.07.049302448432-s2.0-85053676338WOS:000452248400029https://scholars.lib.ntu.edu.tw/handle/123456789/467879