Abstract 4373565: Long-team outcome of common carotid artery occlusion: endovascular treatment VS open surgical treatment

Objective: The objective of this study was to introduce our institutional experience of treatment strategies (endovascular treatment and open surgical treatment) for the common carotid artery occlusion (CCAO). Methods: We retrospectively analyzed 28 consecutive patients with CCAO treated by different treatment strategies (endovascular treatment and open surgical treatment) in our institution from September 2015 to August 2023. Baseline data, surgery-related data, postoperative information and long-term follow-up were assessed. Results: A total of 29 CCAOs in 28 consecutive patients were treated in our institution. The baseline data of common carotid artery reconstruction in the endovascular treatment group and the open surgical treatment group was no statistically significant difference.The success rates of common carotid artery reconstruction in the endovascular treatment group and the open surgical treatment group were 77.8% and 100% (p=0.265). The contrast agent volume of the endovascular treatment group was significantly more than that of the open surgical treatment group, which were 160.00（115.00-190.00）ml and 0.00（0.00-0.00）ml, respectively (p<0.05). Postoperative drainage volume, drainage duration, and hospital stay were all significantly lower in the endovascular treatment group compared with the open surgical treatment group (p < 0.05). All patients in the open surgical treatment group achieved complete resolution of preoperative symptoms, whereas only 22.22% of patients in the endovascular treatment group had complete symptom resolution (p < 0.05). In the endovascular treatment group, the rates of freedom from re-occlusion and reintervention at 1, 3, 6, 12, 36, 60 and 84 months postoperatively were 100.00%, 90.91%, 63.64%, 60.00%, 37.50%, 16.67% and16.67%. In the open surgical treatment group, the rates of freedom from re-occlusion and reintervention at 1, 3, 6, 12, 36, 60 and 84 months postoperatively were 90.00%, 90.00%, 90.00%, 75.00%, 75.00%, 66.70% and 66.70%. Conclusions: For patients with CCAOs, the advantage of endovascular treatment is that it is minimally invasive and suitable for patients with Takayasu arteritis. The advantage of open surgical treatment is that it has a high success rate, and the long-term rate of freedom from reocclusion and reintervention is significantly better than that of endovascular treatment.