Progression of carotid near-occlusion to complete occlusion: related factors and clinical implications.

Autor:	García-Pastor A; Hospital General Universitario Gregorio Marañón, Madrid, Spain angarpas@yahoo.es., Gil-Núñez A; Hospital General Universitario Gregorio Marañón, Madrid, Spain., Ramírez-Moreno JM; Hospital Universitario Infanta Cristina, Badajoz, Spain., González-Nafría N; Complejo Asistencial Universitario de León, León, Spain., Tejada J; Complejo Asistencial Universitario de León, León, Spain., Moniche F; Hospital Universitario Virgen del Rocio, Seville, Spain., Portilla-Cuenca JC; Hospital San Pedro de Alcántara, Caceres, Spain., Martínez-Sánchez P; Hospital Universitario La Paz, Madrid, Spain., Fuentes B; Hospital Universitario La Paz, Madrid, Spain., Gamero-García MÁ; Hospital Universitario Virgen Macarena, Sevilla, Spain., Alonso de Leciñana M; Hospital Universitario Ramón y Cajal, Madrid, Spain., Masjuan J; Hospital Universitario Ramón y Cajal, Madrid, Spain., Cánovas D; Hospital Parc Taulí, Sabadell, Spain., Aladro Y; Hospital Universitario de Getafe, Getafe, Spain., Parkhutik V; Hospital Universitari i Politècnic La Fe, Valencia, Spain., Lago A; Hospital Universitari i Politècnic La Fe, Valencia, Spain., De Arce AM; Hospital Universitario de Donostia, San Sebastian, Spain., Usero-Ruiz M; Hospital Clinico Universitario de Valladolid, Valladolid, Spain., Delgado-Mederos R; Hospital de la Santa Creu I Sant Pau, Barcelona, Spain., Pampliega A; Hospital General Universitari d'Alacant, Alicante, Spain., Ximénez-Carrillo Á; Hospital Universitario de La Princesa, Madrid, Spain., Bártulos-Iglesias M; Complejo Asistencial Univeristario de Burgos, Burgos, Spain., Castro-Reyes E; Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Jazyk:	angličtina
Zdroj:	Journal of neurointerventional surgery [J Neurointerv Surg] 2020 Dec; Vol. 12 (12), pp. 1180-1185. Date of Electronic Publication: 2020 Apr 10.
DOI:	10.1136/neurintsurg-2019-015638
Abstrakt:	Background: The clinical consequences and factors related to the progression from a carotid near-occlusion (CNO) to a complete occlusion are not well established. Our aim is to describe the rate, predictive factors and clinical implications of the progression to complete carotid occlusion (PCCO) in a population of patients with symptomatic CNO. Methods: We conducted a multicenter, nationwide, prospective study from January 2010 to May 2016. Patients with angiography-confirmed CNO were included. We collected information on demographic data, clinical manifestations, radiological and hemodynamic findings, and treatment modalities. A 24 month carotid-imaging follow-up of the CNO was performed. Results: 141 patients were included in the study, and carotid-imaging follow-up was performed in 122 patients. PCCO occurred in 40 patients (32.8%), and was more frequent in medically-treated patients (34 out of 61; 55.7%) compared with patients treated with revascularization (6 out of 61; 9.8%) (p<0.001). 7 of the 40 patients with PCCO (17.5%) suffered ipsilateral symptoms. Factors independently related with PCCO in the multivariate analysis were: age ≥75 years (OR 2.93, 95% CI 1.05 to 8.13), revascularization (OR 0.07, 95% CI 0.02 to 0.20), and collateral circulation through the ipsilateral ophthalmic artery (OR 3.25, 95% CI 1.01 to 10.48). Conclusions: PCCO occurred within 24 months in more than half of the patients under medical treatment. Most episodes of PCCO were not associated with ipsilateral symptoms. Revascularization reduces the risk of PCCO. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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