Document Detail


Recanalization of symptomatic carotid artery dissections causing occlusion with multiple stents: the use of delayed double-contrast road map.
MedLine Citation:
PMID:  20003685     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Internal carotid artery dissections (ICADs) with occlusion present with a high morbidity and mortality. No specific medical treatment has proven to be effective in this setting. In selected cases of ICAD with occlusion, stent-assisted angioplasty has been shown to be effective in restoring the perfusion. Spontaneous ICAD causing occlusion successfully recanalized with multiple telescoped stents extending intracranially has only been reported exceptionally. METHODS: We report cases of symptomatic acute carotid occlusion after spontaneous dissection extending from the cervical to the petrocavernous ICA segments. Imaging studies revealed the presence of an extensive penumbra area in every case. Patients were treated by means of multiple stents deployed in a telescoped fashion with the aid of a delayed double-contrast road map. RESULTS: Post-procedural angiography demonstrated restitution of the carotid lumen with no signs of residual dissection or intracranial emboli. The patients improved rapidly, showing no residual neurological deficit after a week. At follow-up, patients are clinically asymptomatic and the vessel is patent with no radiological signs of myointimal hyperplasia. CONCLUSIONS: The successful angiographic and clinical results observed in our cases of extraintracranial stenting of a long carotid dissection causing occlusion contribute to the literature of carotid dissection treated with multiple stents.
Authors:
José E Cohen; John M Gomori; Ronen R Leker; Tamir Ben-Hur; Savvas Grigoriadis; Gustavo Rajz
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Neurological research     Volume:  32     ISSN:  1743-1328     ISO Abbreviation:  Neurol. Res.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-22     Completed Date:  2010-07-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7905298     Medline TA:  Neurol Res     Country:  England    
Other Details:
Languages:  eng     Pagination:  293-6     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Hadassah University Medical Center, Jerusalem, Israel.
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MeSH Terms
Descriptor/Qualifier:
Blood Vessel Prosthesis Implantation / instrumentation,  methods*
Carotid Artery, Internal, Dissection / surgery*
Carotid Stenosis / surgery
Cerebral Angiography / methods*
Contrast Media / diagnostic use*
Humans
Male
Middle Aged
Radiographic Image Enhancement / methods
Stents*
Stroke / etiology,  surgery
Chemical
Reg. No./Substance:
0/Contrast Media

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


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