To preliminarily study the efficacy and superiority of hybrid surgery in the treatment of chronic internal carotid artery occlusion.

The clinical data of 20 patients with chronic internal carotid artery occlusion treated with hybrid surgery (carotid intima stripped combined interventional balloon expansion) in the Department of Neurosurgery, Shenzhen second People's Hospital from January 2020 to September 2022 were retrospectively collected. The recanalization and prognosis of the patients after hybrid surgery were analyzed. Paired sample t test was used to compare the preoperative and postoperative diameters of the distal vessels of the occlusive internal carotid artery, and to determine whether the hybrid surgical treatment can help restore the diameter of the distal vessels of the internal carotid artery, so as to increase the cerebral tissue perfusion.

Twenty cases were treated by hybrid operation. Among them, 19 cases had immediate recanalization of internal carotid artery after operation, and another case had recanalization failure. No complications, such as cerebral infarction, cerebral hemorrhage, or neurological dysfunction, occurred. Statistical analysis results showed at the distal end of the occlusive internal carotid artery, the mean baseline vascular diameter was (1.35±0.13)mm before treatment and (2.41±0.11)mm after the hybrid operation. The difference of vascular diameter before and after the operation was (1.06±0.08)mm, 95%CI of the difference: 1.02-1.10. the average level of vascular diameter after surgical treatment was higher than that before treatment, and the difference was statistically significant (t=58.160, P＜0001). As for 1-year follow-up, 18 patients with successful cases returned to the court review of cerebral CT examination suggests that recanalization was good; Another one case of successful cases of patients with review of cerebral CT in vascular surgery side severe stricture, during the second step in stent implantation, successful cases during the follow-up of patients with no complications such as cerebral hemorrhage or cerebral infarction. The mental state and cognitive function were significantly improved. One patient with recanalization failure had good psychological and movement condition and other conditions during the follow-up, and no related complications occurred.

Hybrid operation of recanalization occluded has clear curative effect and the recovery of distal vascular blood flow was statistically significant, Hybrid surgery can effectively solve the limitations of single operation and improves the success rate of surgery and reduce the complications related to the operation.