Endovascular treatment of iatrogenic and traumatic carotid artery dissection.
This paper reports on the early and midterm results of endovascular treatment of acute carotid artery dissections, its specific problems, and its limitations. We encountered seven patients with symptomatic extracranial carotid artery dissection, three cases of which occurred after carotid endarterectomy, two after carotid angioplasty and stenting, and two after trauma. Balloon-expandable and self-expanding stents were placed using a transfemoral approach. Success in restoring the carotid lumen was achieved in all patients. No procedure-related complications occurred. All patients experienced significant clinical improvement while in the hospital and achieved complete long-term recovery. At follow-up (mean, 22.4 months), good luminal patency of the stented segments was observed. In conclusion, in this small series, primary stent-supported angioplasty seems to be a safe and effective strategy in the treatment of selected patients having acute traumatic extracranial carotid artery dissection, with excellent early and midterm results. Larger series and longer-term follow-up are required before definitive recommendations can be made.
Schulte
Stefan
S
Department of Vascular Surgery, Hospital Porz am Rhein, Academic Teaching Hospital of the University of Cologne, Urbacher Weg 19, D-51149, Cologne, Germany.
Donas
Konstantinos P
KP
Pitoulias
Georgios A
GA
Horsch
Svante
S
D000208:Acute Disease; D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery; D015901:Angiography, Digital Subtraction; D017130:Angioplasty / Q000379:methods*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D020215:Carotid Artery, Internal, Dissection / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D015607:Stents; D015996:Survival Rate; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000150:complications*