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Occlusive concomitant dissections of the carotid and coronary arteries treated with stent placement

David Orion1, Shady Jahshan, Adnan H Siddiqui

  • 1Department of Neurosurgery and Toshiba Stroke Research Center, University at Buffalo, New York, NY 14209, USA.

Journal of Neurointerventional Surgery
|December 2, 2011
PubMed

Insights

Spontaneous coronary artery dissection and carotid artery dissection are rare conditions. This case report details successful stent treatment for both dissections in a young patient experiencing acute coronary syndrome and ischemic stroke.

Area of Science:

  • Cardiology
  • Neurology
  • Vascular Medicine

Background:

  • Spontaneous coronary artery dissection (SCAD) is uncommon and historically linked to high mortality.
  • Spontaneous internal carotid artery dissection (ICAD) is a significant cause of ischemic stroke, particularly in younger individuals.
  • While medical management often suffices for ICAD, endovascular stenting is an option for select cases.

Observation:

  • A patient in their late 30s presented with a symptomatic occlusive cervical carotid artery dissection.
  • Seven days post-initial presentation, the patient developed acute coronary syndrome.
  • The acute coronary syndrome was attributed to an occlusive dissection of the intermediate coronary artery.

Findings:

  • Both the carotid artery dissection and the coronary artery dissection were successfully treated with stent placement.
  • This dual intervention addressed both ischemic stroke and acute coronary syndrome in the same patient.
  • The case highlights the potential for simultaneous or sequential spontaneous arterial dissections.

Implications:

  • Stent placement can be an effective therapeutic option for managing complex cases of spontaneous arterial dissections affecting both cerebrovascular and coronary arteries.
  • This case broadens the understanding of spontaneous arterial dissection presentations and management strategies.
  • Further research may elucidate the underlying mechanisms and optimal treatment algorithms for patients with multiple spontaneous arterial dissections.

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