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Updated: Jul 5, 2025
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Pathological migrating intramural hematoma in stenting for carotid artery dissection: A ten-year consecutive cohort
Lizhang Chen1, Fayun Hu1, Shuju Dong2
1Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu, Sichuan Province, China.
Insights
Pathological migrating intramural hematoma (PMIH) occurs in 10.4% of carotid artery dissection stenting cases. Early intervention with angioplasty or stenting is crucial for managing new stenosis caused by PMIH to prevent ischemic events.
Area of Science:
- Vascular Surgery
- Interventional Neurology
- Cardiovascular Research
Background:
- Carotid artery dissection (CAD) is a significant cause of stroke.
- Stenting is a treatment option for CAD, but potential complications require study.
- Pathological migrating intramural hematoma (PMIH) is a rare complication of stenting.
Purpose of the Study:
- To investigate the incidence of PMIH in patients undergoing stenting for CAD.
- To identify factors associated with PMIH.
- To establish a management strategy for PMIH.
Main Methods:
- Retrospective analysis of 67 CAD patients treated with stenting over a 10-year period.
- Evaluation of PMIH incidence, timing, location, and associated factors.
- Review of management strategies and clinical outcomes.
Main Results:
- PMIH occurred in 7 patients (10.4%) with a median symptom-to-stenting time of 5 days.
- PMIH was observed in both proximal (4 cases) and distal (3 cases) stent segments.
- All patients presented with new stenosis; no dissecting aneurysms were noted. Proper management led to no clinical complications.
Conclusions:
- The phenomenon of PMIH exists in carotid artery dissection stenting.
- Early treatment with angioplasty or stenting is recommended for moderate to severe stenosis caused by PMIH.
- Timely intervention is essential to prevent further ischemic events.
Objective:
To study the phenomenon, incidence and management of pathological migrating intramural hematoma in stenting for carotid artery dissection.
Methods:
We consecutively enrolled CAD patients with stenting treatment over 10-year period, and retrospectively analyzed the pathological migrating intramural hematoma (PMIH) incidence of these CAD patients. Besides, we also explored the related factors with PMIH and provided an appropriate management strategy.
Results:
A total of 67 CAD underwent stenting. PMIH occurred in 7 cases (10.4%). The median time from onset of symptoms to stenting was 5 days (3 to 11 days). There were 4 cases of PMIH in the proximal segment of stent and 3 cases of PMIH in the distal segment of stent. All the patients presented with new stenosis and no patient presented with dissecting aneurysm. Through proper management, none of the patients had occurred clinical complications.
Conclusion:
Pathological migrating intramural hematoma phenomenon exists in the stenting for carotid artery dissection, rescue angioplasty or stenting is needed for early treatment of moderate and severe stenosis due to migrating intramural hematoma on preventing further ischemic events.
