BIAS technique in recanalization of symptomatic long-type chronic internal carotid artery occlusion

Background Due to the high risk and difficulty, endovascular treatment for symptomatic long-type chronic internal carotid artery occlusion still has not be recommended widely. Methods Patients underwent EVT with symptomatic long-type chronic internal carotid artery occlusion were enrolled, long-type occlusion was defined as the occlusion site from C1 to at least C4. Patients achieved recanalization were divided into 2 groups according to the strategy of operation. Recanalization based on balloon-catheter interaction was categorized as BIAS Group, and recanalization with other way was categorized as Control group. The rate of recanalization, peri-procedural complications, numbers of stent and time spent were evaluated. Results Among the 62 patients who received EVT, 54 (87.1%) achieved successful recanalization. The rate of peri-procedural complications was 19.3% (12/62), symptomatic complications rate was 6.5% (4/62), BIAS Group showed lower complications rate (P = 0.02). The BIAS showed fewer embolism (4.0% vs 13.8%, P = 0.36), but no significant difference. Rate of intracranial hemorrhage and reocclusion within 72h after recanalization showed no significant difference. Time of recanalization was greatly shortened by BIAS technique (58.9 ± 5.7 Vs 104.4 ± 11.3, P = 0.004), and the use of stents also reduced [1(1, 2) Vs 2 (1, 4), P = 0.03]. Conclusion BIAS technique could partly reduce the occurrence of peri-procedural complications. Moreover, it could greatly shorten the time of recanalization and reduced the use of stent. Trial registration Our study is a retrospective study, not a prospective study, we have not registered for the study.