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Iatrogenic cervical artery dissections during endovascular interventions.
Helena Xeros1, Bilal Bucak1, Soliman Oushy2
1Department of Neurology, Mayo Clinic, Rochester, MN, USA.
Summary
Iatrogenic cervical artery dissection (CeAD) from endovascular procedures is rare but usually benign. Most patients recover well with antiplatelet therapy, showing excellent outcomes.
Area of Science:
- Neurology
- Interventional Radiology
- Vascular Surgery
Background:
- Iatrogenic cervical artery dissection (CeAD) is a rare complication of endovascular procedures.
- Limited literature exists on the management and outcomes of iatrogenic CeAD.
Purpose of the Study:
- To investigate the approaches and outcomes of iatrogenic CeAD following endovascular interventions.
- To analyze patient factors, management strategies, and radiological outcomes.
Main Methods:
- Retrospective review of patients with iatrogenic CeAD after endovascular intervention at Mayo Clinic (1998-2021).
- Extraction of pertinent patient factors and generation of descriptive statistics.
Main Results:
- 32 cases of iatrogenic CeAD identified among 21,191 patients undergoing cerebral angiography.
- Most common procedures leading to CeAD were intracranial aneurysm treatment/coiling (46.9%) and diagnostic angiograms (28.1%).
- 93.7% of patients received antithrombotic therapy (aspirin or dual-antiplatelet therapy) for a median of three months, with excellent radiological outcomes.
Conclusions:
- Iatrogenic CeAD following endovascular interventions is rare and typically benign, with most cases managed medically.
- Oral antiplatelet therapies are preferred over intravenous anticoagulation, with treatment durations varying.
- Clinical decisions are influenced by factors such as occlusion, pseudoaneurysm formation, and intracranial extension.
