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Updated: Jun 17, 2026
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Recanalization of symptomatic carotid artery dissections causing occlusion with multiple stents: the use of delayed
José E Cohen1, John M Gomori, Ronen R Leker
1Department of Neurosurgery, Hadassah University Medical Center, Jerusalem, Israel.
Insights
Multiple telescoped stents successfully recanalized spontaneous internal carotid artery dissections causing occlusion, restoring blood flow and improving patient outcomes. This endovascular technique offers a promising treatment for complex carotid dissections.
Area of Science:
- Neurology
- Vascular Surgery
- Interventional Radiology
Background:
- Internal carotid artery dissections (ICADs) with occlusion are associated with high morbidity and mortality.
- No definitive medical treatment exists for ICADs with occlusion.
- Stent-assisted angioplasty is effective for restoring perfusion in selected ICAD cases.
Observation:
- This study reports on symptomatic acute carotid occlusion following spontaneous dissection extending from cervical to petrocavernous internal carotid artery segments.
- Imaging revealed extensive penumbra areas in all patients.
- Treatment involved multiple telescoped stents deployed using a delayed double-contrast roadmap.
Findings:
- Angiography confirmed successful recanalization of the carotid lumen without residual dissection or intracranial emboli.
- Patients showed rapid improvement with no neurological deficits after one week.
- Follow-up demonstrated patent vessels and asymptomatic patients without signs of myointimal hyperplasia.
Implications:
- Extracranial-intracranial stenting with multiple telescoped stents is a viable treatment for long carotid dissections causing occlusion.
- This technique contributes to the literature on managing complex carotid dissections.
- Successful outcomes suggest potential for improved patient prognosis in challenging cases.
Background And Purpose:
Internal carotid artery dissections (ICADs) with occlusion present with a high morbidity and mortality. No specific medical treatment has proven to be effective in this setting. In selected cases of ICAD with occlusion, stent-assisted angioplasty has been shown to be effective in restoring the perfusion. Spontaneous ICAD causing occlusion successfully recanalized with multiple telescoped stents extending intracranially has only been reported exceptionally.
Methods:
We report cases of symptomatic acute carotid occlusion after spontaneous dissection extending from the cervical to the petrocavernous ICA segments. Imaging studies revealed the presence of an extensive penumbra area in every case. Patients were treated by means of multiple stents deployed in a telescoped fashion with the aid of a delayed double-contrast road map.
Results:
Post-procedural angiography demonstrated restitution of the carotid lumen with no signs of residual dissection or intracranial emboli. The patients improved rapidly, showing no residual neurological deficit after a week. At follow-up, patients are clinically asymptomatic and the vessel is patent with no radiological signs of myointimal hyperplasia.
Conclusions:
The successful angiographic and clinical results observed in our cases of extraintracranial stenting of a long carotid dissection causing occlusion contribute to the literature of carotid dissection treated with multiple stents.
