Intra-arterial thrombolysis and stent placement for traumatic carotid dissection with subsequent stroke: a combined, simultaneous endovascular approach.
Traumatic carotid dissection is a well-known cause of ischemic stroke and although the treatment of the dissection itself has received some attention in recent years, the treatment of the concomitant stroke has been less investigated. We present a 43-year-old patient with blunt traumatic internal carotid artery dissection associated with subocclusive stenosis and major cerebral thromboembolic complication. Combined, simultaneous intra-arterial fibrinolysis and carotid stenting through a bilateral approach was successfully performed allowing the complete clinical recovery of the patient. Contralateral carotid artery approach allowed the beginning of intra-arterial thrombolysis without delay, while stent-assisted angioplasty of the injured carotid was simultaneously performed. This approach was proved to be safe and effective and may deserve further evaluation.
Cohen
Jose E
JE
Department of Neurosurgery, Hadassah Hebrew University Hospital, Jerusalem, Israel; Department of Radiology, Hadassah Hebrew University Hospital, Jerusalem, Israel.
Gomori
John M
JM
Grigoriadis
Savvas
S
Elazary
Ram
R
Almogy
Gideon
G
Zamir
Gideon
G
Rivkind
Avraham Y
AY
Khalaileh
Aved
A
D000328:Adult; D000792:Angiography / Q000379:methods; D020215:Carotid Artery, Internal, Dissection / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D008297:Male; D015607:Stents; D020521:Stroke / Q000150:complications*; D015912:Thrombolytic Therapy / Q000379:methods*