Treatment of symptomatic cervical carotid dissections with endovascular stents.
OBJECTIVE
Symptomatic dissections of the cervical carotid artery (CCA) can be spontaneous or secondary to trauma and may be associated with pseudoaneurysms. Surgical treatment is often difficult or unavailable. We report the successful use of endovascular stents in the treatment of symptomatic dissection of the CCA.


METHODS
Five consecutive patients with symptomatic CCA dissection were seen at our institution. There were four female patients and one male patient, ranging in age from 19 to 56 years. One dissection was spontaneous. The others were secondary to a gunshot wound (one patient), blunt neck trauma (two patients), and endovascular treatment of atherosclerotic carotid bifurcation disease (one patient). Balloon-expandable and self-expanding stents were placed via a transfemoral approach.


RESULTS
Success in restoring the carotid lumen with two to five stents in each patient was angiographically demonstrated. There were no procedure-related complications. All patients experienced significant clinical improvement within the first 24 hours and complete long-term recovery.


CONCLUSIONS
Symptomatic dissections of the CCA can be successfully treated by using endovascular stents.
Bejjani
G K
GK
Department of Neurosurgery, George Washington University Medical Center, Washington, District of Columbia, USA.
Monsein
L H
LH
Laird
J R
JR
Satler
L F
LF
Starnes
B W
BW
Aulisi
E F
EF
D000328:Adult; D000784:Aortic Dissection / Q000628:therapy*; D019917:Blood Vessel Prosthesis Implantation; D002340:Carotid Artery Diseases / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000098:blood supply*; D015607:Stents