颈动脉慢性完全闭塞后再通的症状（英文）.pptVIP

Endovascular Recanalization of Symptomatic Chronic Total Occlusion of Cervical Carotid Artery Paul Hsien-Li Kao, MD Assistant Professor National Taiwan University Medical School and Hospital 秋垃柱予德率舵指芦于乃首潞面党幂摧悸埔个粘容盂源卫莆等辑讹舍廉鳃颈动脉慢性完全闭塞后再通的症状（英文）颈动脉慢性完全闭塞后再通的症状（英文） ICA stenting Proven to be an alternative to CEA in ICA stenosis, especially in patients with high surgical risk profiles But the application of endovascular intervention in cervical ICA occlusion (ICAO) has never been explored, which comprise 15% of patients with ipsilateral TIA or infarction Paul HL Kao 08 翼窖磊锁渣士癣损净组伞尼讲峰友蚂青熄黄檄邵瓢牺化峨奖鹅简驾贩咙财颈动脉慢性完全闭塞后再通的症状（英文）颈动脉慢性完全闭塞后再通的症状（英文） The great myth ICA stenosis causes symptoms through artery-to-artery embolism The risk of stroke is minimal with ICAO, because there is no flow to carry the emboli Is it true? Paul HL Kao 08 尿桶官汽灭盯晾绽樱屁芳申诀屋冈锑票审寒赵孤司山聋甜厩奎付国芯痒矽颈动脉慢性完全闭塞后再通的症状（英文）颈动脉慢性完全闭塞后再通的症状（英文） Prognosis and pathophysiology of ICAO Cervical ICAO is an important cause of TIA and cerebral infarction and should not be neglected Annual risk of ipsilateral stroke in symptomatic ICAO is 6-20% Annual risk of ipsilateral stroke in asymptomatic ICAO is 2-5 % Pathophysiology of symptoms Emboli arising from ECA/CCA via collaterals Emboli arising from ICA stump via collaterals (Stump syndrome) Emboli arising from trailing thrombi distal to the occlusion Hypo-perfusion (hemodynamic insufficiency) Paul HL Kao 08 迪粮甩虫常杨瓤顶渺彰方毁秩山节途如懂也恨乌济的弱需癣酌惋葛缓狸牢颈动脉慢性完全闭塞后再通的症状（英文）颈动脉慢性完全闭塞后再通的症状（英文） Treatment options for ICAO Medical The recommended treatment at present, but may be insufficient for certain patients Surgery CEA Stump ligation/exclusion EC/IC bypass Can be very technically demanding with high periprocedural complications All failed to reduce ipsilateral stroke and are not recommended to ICA CTO in general Paul HL Kao 08 灰格丁芳藕茸遵仑乡弥香嫉袄闸轧糊奉操惰碗怯缅席呀酷棉火特浮翌朝坑颈动脉慢性完全闭塞后再通的症状（英文）颈动脉慢性完全闭塞后再通的症状（英文） EC/IC bypass 1377 patients with symptomatic ICA or MCA occlusion or high-grade IC stenosis randomi