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Case reports
Occlusive concomitant dissections of the carotid and coronary arteries treated with stent placement
  1. David Orion1,2,
  2. Shady Jahshan1,2,
  3. Adnan H Siddiqui1,2,3
  1. 1Department of Neurosurgery and Toshiba Stroke Research Center, University at Buffalo, New York, NY, USA
  2. 2Department of Neurosurgery, Millard Fillmore Gates Circle Hospital, Kaleida Health, Buffalo NY, USA
  3. 3Department of Radiology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, NY, USA
  1. Correspondence to Dr A H Siddiqui, Department of Neurosurgery, University at Buffalo, State University of New York, 3 Gates Circle, Buffalo, NY 14209, USA; adnan.h.siddiqui{at}gmail.com

Abstract

Spontaneous coronary artery dissection is rare and previously was associated with a high mortality rate. Spontaneous dissection of the internal carotid artery is a cause of ischemic stroke, especially in young patients. Medical therapy allows healing of the carotid dissection in most patients, although endovascular stent placement has been reported for the treatment of selected cases. A case is reported of a patient in their late 30s who presented with a symptomatic occlusive cervical carotid artery dissection and, 7 days later, developed an acute coronary syndrome due to an occlusive dissection of the intermediate artery. Both lesions were treated with stent placement.

https://doi.org/10.1136/neurintsurg-2011-010151

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    Footnotes

    • Competing interests AHS has received research grants from the National Institutes of Health (co-investigator: NINDS 1R01NS064592-01A1, Hemodynamic induction of pathologic remodeling leading to intracranial aneurysms; not related to present manuscript) and the University at Buffalo (Research Development Award); holds financial interests in Hotspur, Intratech Medical, StimSox and Valor Medical; serves as a consultant to Codman and Shurtleff Inc, Concentric Medical, ev3/Covidien Vascular Therapies, GuidePoint Global Consulting and Penumbra; belongs to the speakers' bureaus of Codman and Shurtleff Inc and Genentech; serves on an advisory board for Codman and Shurtleff; and has received honoraria from Abbott Vascular, American Association of Neurological Surgeons' courses, an emergency medicine conference, Genentech and Neocure Group LLC, and from Abbott Vascular and Codman and Shurtleff Inc for training other neurointerventionists in carotid stenting and for training physicians in endovascular stenting for aneurysms. AHS receives no consulting salary arrangements. All consulting is per project and/or per hour.

    • Patient consent Detail has been removed from this case description to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

    • Ethics approval Our local institutional review board, the Health Sciences Institutional Review Board, University at Buffalo, State University of New York (Buffalo, New York, USA), does not require approval in conjunction with a case report/literature review. The principles of the Declaration of Helsinki were followed.

    • Provenance and peer review Not commissioned; externally peer reviewed.