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Stroke Prevention in Cervical Artery Dissection.
1Department of Neurology, Loyola University Chicago, Stritch School of Medicine, Maywood, IL, 560153, USA. rick.gill@lumc.edu.
Current Cardiology Reports
|October 23, 2021
Summary
Optimal antithrombotic treatment for cervical artery dissection (CAD) remains uncertain. While anticoagulation did not prove superior to antiplatelet agents in preventing stroke, antiplatelet therapy
Area of Science:
- Neurology
- Vascular Medicine
- Cardiology
Background:
- Cervical artery dissection (CAD) is a significant cause of stroke in younger adults.
- Antithrombotic treatment choice for CAD, either antiplatelet (AP) or anticoagulant (AC), is challenging.
- Historical practices favored AC, but evidence remains debated.
Purpose of the Study:
- To review clinical features and imaging of CAD.
- To discuss acute treatment and stroke prevention strategies for CAD.
- To evaluate current antithrombotic management options for CAD.
Main Methods:
- Review of clinical features and imaging in CAD.
- Analysis of findings from major randomized trials (CADISS, TREAT-CAD).
- Discussion of current and future antithrombotic treatment strategies.
Main Results:
- The CADISS trial showed AC was not superior to AP agents for stroke prevention at 3 months.
- The TREAT-CAD trial did not confirm the non-inferiority of AP therapy.
- Optimal antithrombotic management for CAD stroke prevention remains uncertain.
Conclusions:
- Neither AC nor AP therapy has definitively proven superior for stroke prevention in CAD.
- Further research is needed, potentially exploring dual AP therapy or novel oral anticoagulants.
- Aggregating data from existing trials may clarify optimal treatment pathways.
