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Endovascular reconstruction of high cervical and long-segment carotid artery dissections with Leo plus stent
Guang-Dong Lu1, Wei Yang1, Zhen-Yu Jia1
1Department of Interventional Radiology, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Gulou District, Nanjing, 210029, Jiangsu, China.
Insights
Endovascular reconstruction using the Leo plus stent is a safe and effective treatment for challenging high cervical and long-segment carotid artery dissections (CADs). This method shows promising long-term results with no stroke events and high stent patency.
Area of Science:
- Vascular Surgery
- Interventional Neurology
- Medical Device Technology
Background:
- Endovascular reconstruction offers an alternative for carotid artery dissections (CADs) unresponsive to antithrombotic therapy.
- High cervical and long-segment CADs present significant endovascular treatment challenges due to location and anatomy.
Purpose of the Study:
- To evaluate the safety and efficacy of endovascular reconstruction using the Leo plus stent for high cervical and long-segment CADs.
- To present clinical experiences and outcomes of this specific endovascular approach.
Main Methods:
- Retrospective review of patients with high cervical and long-segment CADs treated with the Leo plus stent.
- Analysis of patient demographics, clinical presentations, procedural details, complications, and follow-up data.
Main Results:
- 17 patients with CADs were treated; 7 had pseudoaneurysms. Mean dissection length was 5.7 cm, with 92.3% stenosis.
- Successful stent deployment in all cases, with a mean residual stenosis of 22.2%. No perioperative complications.
- Median follow-up of 29 months showed no ischemic stroke events, high stent patency, and resolution of pseudoaneurysms.
Conclusions:
- Endovascular reconstruction with the Leo plus stent is a practical, safe, and effective treatment for complex CADs.
- Long-term follow-up supports the Leo plus stent as a suitable option for managing high cervical and long-segment carotid artery dissections.
Purpose:
Endovascular reconstruction has emerged as a viable alternative for carotid artery dissections (CADs) that are unresponsive to antithrombotic therapy. However, high cervical and long-segment CADs pose challenges during endovascular treatment due to their distal location and tortuous anatomy. We presented our experiences using endovascular reconstruction with the Leo plus stent for this type of CAD.
Methods:
We conducted a retrospective review of patients with high cervical and long-segment CADs treated using the Leo plus stent. We analyzed patient demographics, clinical presentations, procedural features, complications, and follow-up outcomes.
Results:
A total of 17 patients (mean age, 48.1 years) with 17 CADs were identified. Seven of these dissections were accompanied by pseudoaneurysm. The mean length of the dissection was 5.7 cm, and the mean degree of stenosis was 92.3%. A single Leo plus stent was deployed in 15 patients, while another Wallstent carotid stent was used in 2 cases. All stents were successfully positioned in their intended sites. The average degree of residual stenosis was 22.2%. There were no perioperative complications. With a median follow-up duration of 29 months, no ischemic stroke events occurred. All but one Leo plus stent remained patent during follow-up, and all 7 pseudoaneurysms had disappeared at the last radiological assessment.
Conclusion:
Our experience in treating high cervical and long-segment CADs with the Leo plus stent demonstrates that this approach is practical, safe, and effective, as evidenced by long-term observations. The Leo Plus stent appears to be a suitable option for managing this type of CAD.
