{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T02:25:09Z","timestamp":1794018309874,"version":"4.8.0"},"reference-count":34,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Endovascular treatment of nonacute symptomatic carotid artery occlusion (NASCAO) remains a technical challenge. The heterogeneity of a successful recanalization rate has limited its clinical efficacy. The aim of this study was to introduce an angiographic classification to determine the feasibility and clinical outcomes of endovascular recanalization for NASCAO patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The authors analyzed consecutive patients who underwent endovascular treatment of NASCAO in a nationwide prospective registry. Patients were divided into 4 occlusion groups according to a novel classification based on distal carotid reconstitution level, distal retrograde stump morphology, and proximal stump morphology. The rate of technical success, procedural complications, 30-day postoperative stroke risk, and long-term clinical outcomes were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Of 425 patients enrolled in the final analysis, the overall successful recanalization rate was 55.8% (237\/425), and the 30-day postoperative major stroke rate was 3.8% (16\/425). The rate of technical success was 80.7% (92\/114) for type A, 80.7% (88\/109) for type B, 40.9% (47\/115) for type C, and 11.5% (10\/87) for type D occlusions (p &lt; 0.001). No differences were found for intraoperative complications and 30-day strokes among the 4 types. During a median follow-up of 37 months, patients with type A and B carotid occlusions had significant lower ischemic cerebrovascular event risk than patients with type C and D occlusions (type A and B vs type C and D: adjusted HR 0.274, 95% CI 0.144\u20130.520; p &lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>In NASCAO patients with recanalization attempts, type A\/B occlusion was associated with a higher success rate and a lower long-term risk of ischemic cerebrovascular event. The NASCAO classification may assist in the selection of appropriate patients for endovascular treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2026.4.jns251437","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:01:16Z","timestamp":1790726476000},"page":"1-8","source":"Crossref","is-referenced-by-count":0,"title":["Angiographic classification of nonacute carotid artery occlusion to predict the feasibility and clinical outcomes of endovascular recanalization"],"prefix":"10.3171","author":[{"given":"Chao","family":"Hou","sequence":"first","affiliation":[{"name":"Department of Neurology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huajuan","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Neurology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuxian","family":"Huo","sequence":"additional","affiliation":[{"name":"Department of Neurology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Neurology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianjun","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital of Wannan Medical College, Wannan Medical College, Wuhu;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Sun","sequence":"additional","affiliation":[{"name":"Stroke Center & Department of Neurology, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guodong","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Guangzhou First People\u2019s Hospital, School of Medicine, South China University of Technology, Guangzhou;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongbing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, Jiangsu Province Hospital of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingyang","family":"Du","sequence":"additional","affiliation":[{"name":"Cerebrovascular Disease Treatment Center, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunfei","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Neurology, Jiangsu Province Hospital of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaobing","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinfeng","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing;"},{"name":"Stroke Center & Department of Neurology, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gelin","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruidong","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Neurology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"8","key":"b1","series-title":"JAMA","first-page":"704","article-title":"Extracranial-intracranial bypass and risk of stroke and death in patients with symptomatic artery occlusion: the CMOSS randomized clinical trial","volume":"330","author":"Ma Y","year":"2023","unstructured":"Ma Y, Wang T, Wang H,  Extracranial-intracranial bypass and risk of stroke and death in patients with symptomatic artery occlusion: the CMOSS randomized clinical trial. 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