Document Detail

R2-recanalization of spontaneous carotid artery dissection.
MedLine Citation:
PMID:  19109549     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: We set out to investigate the predictors and time course for recanalization of spontaneous dissection of the cervical internal carotid artery (SICAD). METHODS: We prospectively included 249 consecutive patients (mean age, 45+/-11 years) with 268 SICAD. Ultrasound examinations were performed at presentation, during the first month, and then at 3, 6, and 12 months, and clinical follow-ups after 3, 6, and 12 months. RESULTS: Of 268 SICADs, 20 (7.5%) presented with <or=50% stenosis, 31 (11.6%) with 51% to 80% stenosis, 92 (34.3%) with 81% to 99% stenosis, and 125 (46.6%) with an occlusion. Antithrombotic treatment included anticoagulation in 174 (67%) patients, aspirin in 64 (24%) patients, and aspirin followed by anticoagulation or vice versa in 22 (8%) patients. Follow-up ultrasound showed normal findings in 160 (60%), <or=50% stenosis in 27 (10%), 51% to 80% stenosis in 4 (1%), 81% to 99% stenosis in 26 (10%), and occlusion in 51 (19%) vessels. The rate of complete recanalization was 16% at 1 month, 50% at 3 months, and 60% at 6 and 12 months. Initial occlusion of the dissected vessels reduced the odds of recanalization (OR, 4.0; 95% CI, 2.2-7.3; P<0.001), whereas the occurrence of local symptoms and signs only at presentation were independently associated with complete recanalization (OR, 0.4; 95% CI, 0.2-0.8; P=0.048). CONCLUSIONS: These results suggest that recanalization of SICAD occurs mainly within the first 6 months after the onset of symptoms. Initial occlusion reduces the likelihood of complete recanalization, whereas presentation with local symptoms and signs only increases it.
Krassen Nedeltchev; Stefan Bickel; Marcel Arnold; Hakan Sarikaya; Dimitrios Georgiadis; Matthias Sturzenegger; Heinrich P Mattle; Ralf W Baumgartner
Related Documents :
12845339 - Current and future therapies for ischemic cerebrovascular disease.
23630549 - Metabolic changes one year after laparoscopic adjustable gastric banding operation in m...
23106799 - The impact of body mass index on surgical outcomes of robotic partial nephrectomy.
20017939 - Effects of intensive arm training with the rehabilitation robot armin ii in chronic str...
20045609 - Protamine reduces bleeding complications associated with carotid endarterectomy without...
15206559 - Successful treatment with succinate in a patient with melas.
1814659 - Rapid preoperative preparation in hyperthyroidism.
23248829 - Comparison of fascia iliaca compartment block and 3-in-1 block in adults undergoing kne...
23613639 - Endoscopic papillary balloon intermittent dilatation and endoscopic sphincterotomy for ...
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-12-24
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  40     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-01-27     Completed Date:  2009-02-20     Revised Date:  2009-10-28    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  499-504     Citation Subset:  IM    
Department of Neurology, University Hospital, Zürich, Switzerland.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Anticoagulants / therapeutic use
Carotid Artery, Internal, Dissection / drug therapy,  pathology*,  ultrasonography
Carotid Stenosis / pathology,  ultrasonography
Fibrinolytic Agents / therapeutic use
Follow-Up Studies
Middle Aged
Neovascularization, Pathologic / drug therapy,  pathology*,  ultrasonography
Prospective Studies
Reg. No./Substance:
0/Anticoagulants; 0/Fibrinolytic Agents
Comment In:
Stroke. 2009 Nov;40(11):e629; author reply e630-1   [PMID:  19762708 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Clinical prediction of functional outcome after ischemic stroke: the surprising importance of perive...
Next Document:  Comparison of definitions of metabolic syndrome in relation to the risk of developing stroke and cor...