Clinical Outcomes of Microsurgical Flow Reconstruction in Long-Segment Cervical Internal Carotid Artery Stenosis with Distal Grade 2 or 3 Kinking

Basit Öğe Kaydı
dc.contributor.authorPınar, E
dc.contributor.authorBaylarov, B
dc.contributor.authorÇekiç, E
dc.contributor.authorAkbulut, F
dc.contributor.authorCoşar, A
dc.contributor.authorÜstün, ME
dc.date.accessioned2026-03-31T13:21:19Z
dc.date.available2026-03-31T13:21:19Z
dc.date.issued2025
dc.description.abstractBackground: To evaluate the clinical outcomes of perivascular sympathectomy-assisted arteriolysis combined with kinking correction in patients with long-segment cervical internal carotid artery (ICA) stenosis accompanied by Grade 2 or 3 distal kinking. Methods: Nineteen patients with symptomatic, nonatherosclerotic, >= 5 cm-long tubular ICA stenosis and distal kinking (Grade 2 or 3) underwent microsurgical decompression between 2017 and 2023. Surgical intervention included circumferential arteriolysis, perivascular sympathectomy, and correction of the kinking. Clinical symptoms such as hemiparesis, dysphasia, seizures, migraine, and tinnitus were assessed preoperatively and postoperatively up to 24 months. Radiological outcomes were evaluated using computed tomography/magnetic resonance angiography and perfusion imaging. Preoperative and postoperative vessel diameters were measured intraoperatively. The analysis used SPSS and statistical significance was set at P < 0.05. Results: Significant postoperative symptom resolution was observed in hemiparesis (100%), motor dysphasia (100%), migraine (88.9%), and seizures (83.3%). Intraoperative diameter of the ICA increased by 1.5-2-fold following sympathectomy (mean preoperative diameter: 3.4 mm; postoperative: 7.5 mm; P < 0.001). Perfusion imaging demonstrated improved cerebral blood flow in the affected vascular territory in all patients. Conclusions: Microsurgical flow reconstruction using arteriolysis and perivascular sympathectomy with kinking correction is a promising technique for selected patients with complex cervical ICA stenosis not amenable to endovascular treatment. It achieves significant symptomatic relief and improves hemodynamic parameters without major complications.
dc.identifier.doi10.1016/j.wneu.2025.124281
dc.identifier.issn1878-8750
dc.identifier.issn1878-8769
dc.identifier.pmid40669597
dc.identifier.urihttp://dx.doi.org/10.1016/j.wneu.2025.124281
dc.identifier.urihttps://hdl.handle.net/11491/9683
dc.identifier.volume201
dc.identifier.wosWOS:001545441700004
dc.language.isoen
dc.publisherELSEVIER SCIENCE INC
dc.relation.ispartofWORLD NEUROSURG
dc.subjectArteriolysis
dc.subjectCervical internal carotid artery
dc.subjectGrade 2 or 3 kinking
dc.subjectLong-segment tubular stenosis
dc.subjectMicrosurgical intervention
dc.subjectPerivascular sympathectomy
dc.titleClinical Outcomes of Microsurgical Flow Reconstruction in Long-Segment Cervical Internal Carotid Artery Stenosis with Distal Grade 2 or 3 Kinking
dc.typeArticle

Dosyalar

Koleksiyon

WoS İndeksli Yayınlar Koleksiyonu