Mechanical Thrombectomy in Patients With Cervical Artery Dissection: A Multicenter Analysis on Technical, Safety, and...

Area of Science:

• Neurology
• Interventional Neuroradiology
• Vascular Medicine

Background:

• Cervical artery dissection (CeAD) is a rare cause of stroke, particularly in younger adults.
• The role of mechanical thrombectomy (MT) in acute ischemic stroke (AIS) secondary to CeAD is not well-established.

Purpose of the Study:

• To evaluate the safety and effectiveness of MT in patients with large vessel occlusion AIS (LVO-AIS) caused by CeAD.
• To compare outcomes of MT in CeAD-related LVO-AIS versus non-CeAD LVO-AIS patients.

Main Methods:

• Retrospective multicenter study of LVO-AIS patients treated with MT (June 2021-June 2024).
• Comparison of CeAD-related LVO-AIS patients with matched non-CeAD AIS patients.
• Meta-analysis of existing studies (2015-2025) to enhance generalizability.

Main Results:

• 164 of 1861 LVO-AIS patients (8.7%) had CeAD.
• CeAD patients had similar procedural adverse events (17.7% vs. 16.3%) and recanalization rates (90.0% vs. 87.5%) compared to non-CeAD patients.
• CeAD patients showed similar 90-day functional outcomes (59.1% vs. 58.5%) but lower mortality (4.3% vs. 13.1%).
• Meta-analysis indicated better MT outcomes in CeAD-related LVO-AIS.

Conclusions:

• Mechanical thrombectomy is a safe and effective treatment for LVO-AIS in patients with CeAD.
• High recanalization rates and favorable functional outcomes are achievable.
• MT outcomes in CeAD-related stroke are comparable to non-CeAD stroke.