Elsevier

Journal of Vascular Surgery

Volume 42, Issue 5, November 2005, Pages 854-860
Journal of Vascular Surgery

Clinical research study
Endovascular management of spontaneous carotid artery dissection

https://doi.org/10.1016/j.jvs.2005.06.029Get rights and content
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Objective

Despite medical therapy, a subset of patients with spontaneous carotid artery dissection (SCD) experience recurrent or progressive symptoms. In this study, we assessed the safety and efficacy of endovascular stent angioplasty in the treatment of SCD.

Methods

Seven consecutive patients with SCD underwent endovascular stent angioplasty of a total of 12 vessels. Indications included the presence of a large or enlarging pseudoaneurysm, a contraindication to anticoagulation, failure of anticoagulation, and compromised cerebral blood flow.

Results

Five patients had fibromuscular dysplasia. All patients tolerated the procedure well, with no adverse clinical events. All patients showed symptomatic improvement on clinical follow-up except for one patient, who had hemorrhagic conversion of a pre-existing large ischemic stroke 13 days after intervention; he made an eventual recovery to baseline. All stents have remained patent on radiologic follow-up.

Conclusions

This study provides additional evidence that endovascular stent angioplasty is a safe and effective treatment for SCD in patients for whom medical treatment is not adequate.

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Competition of interest: none.