title: Long-term clinical and angiographic outcomes in patients with spontaneous cervico-cranial arterial dissections treated with stent placement.
abstract: BACKGROUND
  Limited data exist regarding the long-term clinical and angiographic outcomes of patients with spontaneous cervico-cranial arterial dissection treated with stent placement.
  
  
  OBJECTIVE
  To report the immediate and long-term clinical and angiographic outcomes of patients who received stent placement for spontaneous cervico-cranial arterial dissection.
  
  
  METHODS
  We reviewed clinical and angiographic data of consecutive patients with spontaneous, cervico-cranial arterial dissection treated with stent placement. Patients with recurrent ischemic symptoms or severe hemodynamic compromise despite maximal medical therapy, or those with compressive symptoms due to expanding pseudoaneurysms were considered for stent placement. Follow-up angiography and intravascular ultrasound (in select patients) was performed to detect in-stent restenosis, intimal flap, thrombus, or persistent pseudoaneurysm.
  
  
  RESULTS
  A total of 14 patients were identified, with complete resolution of stenosis achieved in 10 patients immediately post-procedure. Clinical follow-up ranged from 26-900 days, during which there was 1 (7%) TIA, 1 (7%) minor ischemic stroke, and 1 (7%) in hospital death (unrelated to stent placement). Stroke-free survival was 93% at both 1 month and 6 months after the procedure. Follow-up angiography did not reveal any in-stent restenosis.
  
  
  CONCLUSIONS
  This study demonstrates the feasibility, safety, and intermediate term effectiveness of endovascular stent reconstruction of spontaneous, cervico-cranial arterial dissection.
authors.affiliation: Zeenat Qureshi Stroke Research Center, Department of Neurology, University of Minnesota, Minneapolis, Minnesota 55455, USA. ameerehassan@gmail.com
authors.forename: Ameer E
authors.initials: AE
authors.lastname: Hassan
authors.forename: Haralabos
authors.initials: H
authors.lastname: Zacharatos
authors.forename: Gustavo J
authors.initials: GJ
authors.lastname: Rodriguez
authors.forename: M Fareed K
authors.initials: MF
authors.lastname: Suri
authors.forename: Nauman
authors.initials: N
authors.lastname: Tariq
authors.forename: Gabriela
authors.initials: G
authors.lastname: Vazquez
authors.forename: Ramachandra P
authors.initials: RP
authors.lastname: Tummala
authors.forename: Adnan I
authors.initials: AI
authors.lastname: Qureshi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000000981:diagnostic imaging* / Q000601:surgery*; D015901:Angiography, Digital Subtraction; D002533:Cerebral Angiography; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D015996:Survival Rate; D016896:Treatment Outcome