慢性颈内动脉闭塞患者血管内治疗成功的相关因素分析

Related factors of successful endovascular therapy in patients with chronic internal carotid artery occlusion

为了探讨慢性颈内动脉闭塞(CICAO)患者血管内治疗成功的相关因素,回顾性分析2011年1月至2019年5月于苏州大学附属第二医院和苏州市第九人民医院行血管内治疗的73例症状性CICAO患者的临床资料,分为开通组(49例)和未开通组(24例),对两组患者的临床资料进行单因素分析,将部分单因素分析的变量纳入多因素logistic回归分析。结果发现,闭塞颈内动脉远端血液反流至床突段以下(OR=8.946,95%CI:1.782~44.910)、锥形残端(OR=4.488,95%CI:1.147~17.566)是CICAO患者血管内治疗成功的相关因素(均P<0.05);闭塞颈内动脉起始段钙化(OR=0.161,95%CI:0.027~0.965)是CICAO患者血管内治疗成功的不利因素(P<0.05)。本研究表明,锥形残端和闭塞颈内动脉远端血液反流至床突段以下是症状性CICAO患者血管内治疗成功的相关因素;闭塞颈内动脉起始段钙化是CICAO患者血管内治疗成功的不利因素。

The clinical data of 73 symptomatic patients with chronic internal carotid artery occlusion(CICAO)who underwent endovascular therapy in the Second Affiliated Hospital of Soochow University and Suzhou Ninth People′s Hospital from January 2011 to May 2019 were retrospectively analyzed,and the related factors of successful endovascular therapy were determined.The patients were divided into recanalization group(49 cases)and non-recanalization group(24 cases).The related factors of successful endovascular recanalization in patients with symptomatic CICAO were investigated by both univariate and multivariate logistic regression analyses.The results showed that distal ICA reconstitution at the clinoid segment(OR=8.946,95%CI:1.782-44.910)and tapered stump(OR=4.488,95%CI:1.147-17.566)were related factors of successful endovascular therapy in patients with CICAO(both P<0.05).However,calcification at the beginning of occluded ICA(OR=0.161,95%CI:0.027-0.965)was an adverse factor for successful endovascular therapy in patients with CICAO(P<0.05).This study indicates that the related factors of successful ICA endovascular therapy in patients with symptomatic CICAO mainly include tapered stump and distal ICA reconstitution at the clinoid segment,while calcification at the beginning of occluded ICA was an adverse factor.