Mechanical Thrombectomy in Cervical Artery Dissection-Related Stroke

Area of Science:

• Neurology
• Interventional Radiology
• Vascular Medicine

Background:

• Cervical artery dissection (CeAD) can cause large vessel occlusion (LVO) stroke, posing procedural challenges for mechanical thrombectomy (MT).
• Evaluating the safety, efficacy, and outcomes of MT in CeAD patients is crucial for stroke management.

Purpose of the Study:

• To analyze the safety, reperfusion rates, and clinical outcomes of LVO stroke patients treated with MT.
• To compare outcomes between patients with CeAD and those without CeAD undergoing MT.

Main Methods:

• Retrospective analysis of consecutive LVO stroke patients undergoing MT from June 2015 to June 2021.
• Comparison of baseline characteristics, procedural details, recanalization rates, adverse events, and functional outcomes between CeAD and non-CeAD groups.

Main Results:

• CeAD patients (5.3%) were younger with fewer cardiovascular risk factors but more tandem occlusions and longer reperfusion times.
• Recanalization rates (100% vs. 88.5%) and MT-related adverse events (10.0% vs. 10.7%) were similar between groups.
• Functional outcome at 3 months (modified Rankin Scale 0-2) was significantly better in CeAD patients (85.0% vs. 62.0%).

Conclusions:

• Mechanical thrombectomy is a safe and effective treatment for LVO stroke secondary to CeAD.
• Despite procedural complexities, CeAD patients achieve favorable functional outcomes following MT.