title: Acute carotid artery dissection treated with stenting and hematoma aspiration guided by ultrasonography.
abstract: We report the successful treatment of dissection with stenosis of the carotid artery by stenting and aspiration of hematoma. A male patient, presenting with acute blurred vision and weakness and numbness of the right side of his body, was diagnosed with common carotid artery (CCA) dissection and severe stenosis of the internal carotid artery and CCA by digital subtraction arteriography and color Doppler ultrasonography (CDU). Two stents were separately implanted into the left internal carotid artery and CCA to restore blood flow and seal the opening of the dissection. The hematoma inside the CCA dissection was transcutaneously aspirated under CDU guidance after thrombolysis with tissue plasminogen activator. Three days after the operation, the dissection was still sealed. The patient was discharged 1 week later without any signs or symptoms. Follow-up examination at 70 days confirmed complete healing of the CCA dissection. Transcutaneous intradissection hematoma aspiration with CDU guidance may be applicable in treating arterial dissection, especially when conservative treatments cannot be expected to improve severe flow disturbances.
authors.affiliation: Center of Cerebrovascular Disease, No. 404 Hospital of PLA, 8 Baoquan Street, Weihai 264200, China.
authors.forename: Liming
authors.initials: L
authors.lastname: Geng
authors.forename: Changsong
authors.initials: C
authors.lastname: Zha
authors.forename: Hao
authors.initials: H
authors.lastname: Liu
authors.forename: Jianjun
authors.initials: J
authors.lastname: Xu
authors.forename: Yuexia
authors.initials: Y
authors.lastname: Xiang
authors.forename: Zhongmin
authors.initials: Z
authors.lastname: Zou
mesh_terms: D000208:Acute Disease; D000328:Adult; D000784:Aortic Dissection / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D015901:Angiography, Digital Subtraction / Q000379:methods; D001783:Blood Flow Velocity; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000601:surgery; D002340:Carotid Artery Diseases / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D016893:Carotid Stenosis / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D005500:Follow-Up Studies; D006406:Hematoma / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D008297:Male; D015607:Stents; D013396:Suction / Q000379:methods; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D018084:Ultrasonography, Interventional / Q000379:methods*