Hybrid surgery for symptomatic chronic near-total or total occlusion of the internal carotid artery

Wang, Changming; Han, Jintao; Jia, Z C; Yang, Guang-Xin; Li, Xuan

doi:10.1097/cm9.0000000000001373

Cited by 1 publication

(2 citation statements)

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“…At the same time, carotid artery occlusion in the included studies was more prevalent in males than in females (with a mean of 81.3%). The average age of the included patients ranged from 55 to 67 years old, and in one study, the average age of the male and female patients was calculated separately [9], and in another study, the specific sex ratio was not calculated [18] (Table 1).…”

Section: Resultsmentioning

confidence: 99%

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Safety and Efficacy of Hybrid Surgery in Chronic Internal Carotid Artery Occlusion: A Systematic Review and Meta-Analysis

Tan,

Wang,

Xing

et al. 2023

Cerebrovasc Dis

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Introduction: Chronic internal carotid artery occlusion (CICAO) is a common cause of stroke and ischemia recurrence. An increasing number of reports have highlighted the potential of hybrid surgery for treating CICAO. There are few studies, specifically nonrandomized controlled trials, on the safety and effectiveness of hybrid surgery for the treatment of CICAO, so in this study, we hypothesized that hybrid surgery would be safe, have an acceptable complication rate and a high success rate. Methods: MEDLINE, Embase, Cochrane Library, and Web of Science databases were searched for relevant studies published up to January 30, 2023. The primary endpoint was recanalization rates of occluded vessels, and the secondary endpoint was perioperative death and procedure-related complications. Subgroup analysis focused on the recanalization rates of endovascular intervention (EI) and hybrid surgery, as well as the rates of recanalization below the clinoid segment and at the clinoid segment and beyond. The follow-up visit was conducted at least 3 months after surgery, and stenosis or occlusion recurrence was confirmed by review of CTA or DSA scan. Results: The databases were searched and 1,709 records were identified, of which 16 articles were used in the meta-analysis, and 464 CICAO patients with complete data who underwent hybrid surgery were enrolled. Hybrid surgery was associated with higher success rates (RD = 0.87, 95% CI [0.84–0.91], p < 0.00001) than EI (OR = 4.71, 95% CI [2.32–9.56], p < 0.0001). The procedural success rate in the below-clinoid segment group was significantly higher than that in the clinoid segment and beyond group (OR = 13.76, 95% CI [5.31–35.66], p < 0.00001). The total periprocedural complication rate was low (RD = 0.11, 95% CI [0.07–0.15], p < 0.00001 and RD = 0.04, 95% CI [0.00–0.07], p = 0.03). Target vessel restenosis or reocclusion occurred in 35 patients (8%) during the follow-up period (RD = 0.08, 95% CI [0.04–0.12], p < 0.0001). Conclusion: Hybrid surgery is the combination of the advantages of open surgery and EI, has a high success rate and a low risk of recurrence of stenosis and occlusion in the long term. Randomized controlled trials on hybrid surgery for internal carotid artery occlusion are necessary.

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Section: Resultsmentioning

confidence: 99%

“…Duplicate articles, title abstracts, and full texts were screened, and irrelevant articles, case reports, and letters were excluded. One study with carotid stent restenosis hybrid surgery recanalization was excluded, and 16 eligible studies were finally included [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] (Fig. 2).…”

Section: Study Selectionmentioning

confidence: 99%