Primary stent implantation for bilateral spontaneous cervical ICA dissections with hypoperfusion after 72 h from
Yijie Chen1, Ningyuan Zhang2, Yigang Chen1
1Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No.3, East Qingchun Road, Hangzhou, China.
Insights
Primary stent placement at critical sites effectively treats spontaneous cervical internal carotid artery dissection (cICAD) causing stroke. This approach offers a promising option for acute and subacute cICAD with cerebral hypoperfusion.
Area of Science:
- Neurology
- Vascular Surgery
- Interventional Neuroradiology
Background:
- Spontaneous cervical internal carotid artery dissection (cICAD) is a frequent cause of stroke in young adults.
- Endovascular therapy is crucial but presents significant challenges in managing cICAD.
Purpose of the Study:
- To evaluate the efficacy of primary stent implantation at the critical flow-limiting site for spontaneous cICAD.
- To assess the Solitaire stent as a treatment option in acute and subacute stages of cICAD.
Main Methods:
- A case of bilateral spontaneous cICAD with hypoperfusion-related acute ischemic stroke (AIS) was presented.
- The patient underwent primary Solitaire stent detachment at the critical flow-limiting site.
Main Results:
- The patient demonstrated a positive response to the primary Solitaire stent detachment.
- Successful management of cICAD with hypoperfusion was achieved.
Conclusions:
- Primary stent implantation at the critical flow-limiting site is a viable therapeutic option for spontaneous cICAD with cerebral hypoperfusion.
- The Solitaire stent is a suitable choice for treating acute and subacute stages of cICAD.
Background:
Spontaneous cervical internal carotid artery dissection (cICAD) is a common cause of stroke in young adults. Endovascular therapy is an indispensable treatment for cICAD in some cases, but it faces great challenges.
Case Presentation:
A bilateral spontaneous cICADs with hypoperfusion-related AIS after 72 h from the onset was presented herein. The patient responded well to primary Solitaire stent detachment at the critical flow-limiting site.
Conclusions:
Primary stent implantation at the critical flow-limiting site rather than covering the entire dissection may be a therapeutic option in spontaneous cICAD complicated with cerebral hypoperfusion. The Solitaire stent may be a good choice at the acute and subacute stages of cICAD.
