Acute ischemic dissection of an "S"-shaped carotid artery: The "one-stop" value of using a detachable Solitaire AB stent

J Clin Neurosci. 2018 Jul:53:177-182. doi: 10.1016/j.jocn.2018.04.075. Epub 2018 May 9.

Abstract

This study aimed to evaluate the efficacy and safety of endovascular repair using detachable Solitaire AB stents for acute ischemic dissection of "S"-shaped carotid arteries. From May 2015 to December 2016, a total of 127 patients with acute ischemic stroke (AIS) underwent endovascular treatment in our center. Among them, five AISs were due to acute dissection of an "S"-shaped carotid artery. Coexisting carotid embolism was identified in all five patients, who first underwent successful Solitaire AB stent-based retrieval of the embolism. All patients then underwent Solitaire AB stenting to reopen the occluded carotid arteries, all of which were successfully recanalized. There were no procedure-related complications, except for minor hemorrhage transformation in one patient. The mean NIHSS scores were 12 ± 3.7 and 3.8 ± 3.4 at admission and 90 days after stenting, respectively (P = 0.018). The median modified Rankin Scale score at 90 days was 2.0 ± 1.4. Follow-up computed tomography angiography demonstrated in-stent patency in four of the five patients. Dissection of an "S"-shaped carotid artery infrequently leads to AIS. Such dissected arteries can be safely and reliably repaired by this stenting, ensuring successful reconstruction of the carotid arterial circulation.

Keywords: Acute ischemic stroke; Carotid arterial dissection; Endovascular repair; Stent retrieval.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carotid Artery, Internal, Dissection / complications
  • Carotid Artery, Internal, Dissection / surgery*
  • Endovascular Procedures / instrumentation*
  • Endovascular Procedures / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Stents*
  • Stroke / etiology
  • Treatment Outcome