Management of intervenable factors to reduce vascular complications in patients with internal carotid artery occlusion treated by non-emergency endovascular treatment

Guangyu Wu; Yuxin Nong; Shaorui Hong; Shuo Wang; Chengbo Dai; Chizhong He; Changmao Li; Tengyun Ma; Zhexian Yang; Bin Zhang; Yuyuan Gao; Guixian Ma

doi:10.3389/fneur.2024.1332940

Management of intervenable factors to reduce vascular complications in patients with internal carotid artery occlusion treated by non-emergency endovascular treatment

Front Neurol. 2024 Mar 1:15:1332940. doi: 10.3389/fneur.2024.1332940. eCollection 2024.

Authors

Guangyu Wu^#¹, Yuxin Nong^#², Shaorui Hong^#³, Shuo Wang⁴, Chengbo Dai⁴, Chizhong He⁴, Changmao Li⁴, Tengyun Ma⁴, Zhexian Yang⁴, Bin Zhang⁴, Yuyuan Gao⁴, Guixian Ma^#^{1

4}

Affiliations

¹ Department of Neurology, Guangzhou Key Laboratory of Diagnosis and Treatment for Neurodegenerative Diseases, Guangdong Neuroscience Institute, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
² Department of Cardiology, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
³ Shantou University Medical College, Shantou, China.
⁴ Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China.

^# Contributed equally.

Abstract

Objective: This study aims to identify risk factors for vascular complications during non-emergency endovascular treatment in patients with internal carotid artery occlusion (ICAO) and to propose potential interventions.

Method: A retrospective analysis of 92 patients with ICAO who received non-emergency endovascular treatment in our center from 1 January 2018 to 31 June 2023, was conducted. The correlation between intraoperative vascular complications and potential risk factors was studied, and interaction analysis was performed.

Results: Our findings revealed that the use of non-neurology guide wires to open vessels (adjusted OR: 4.1, 95%CI: 1.3-12.8; p = 0.014) and glycosylated hemoglobin (HbA1c) ≥ 6.5 mmol/L (adjusted OR: 3.2, 95%CI: 1.2-8.9; p = 0.023) was significantly associated with vascular complications in non-emergency endovascular treatment of ICAO patients. The restricted cubic spline (RCS) showed that the higher the HbA1c level, the higher the risk of vascular complications.

Conclusion: The use of non-neurology guide wires for vessel opening during non-emergency endovascular treatment in patients with ICAO increases the risk of vascular complications. Preoperative assessment and management of HbA1c levels can reduce the incidence of intraoperative vascular complications.

Keywords: glycosylated hemoglobin; internal carotid artery occlusion; non-emergency endovascular treatment; non-neurology guide wires; vascular complications.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by Science and Technology Program of Guangzhou, China (grant no. 202201011780). The funders had no role in the study design, analysis, decision to publish, nor preparation of the manuscript.