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Extracranial Internal Carotid Artery Dissection Treated with Self-expandable Stents: A Single-Centre Experience

  • Clinical Investigation
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Abstract

Purpose

Treatment of choice for the internal carotid artery dissection (ICAD) is anticoagulation for three to 6 months. Endovascular procedures may be a promising alternative for patients (pts) with haemodynamic impairment, recurrent ischaemic symptoms or symptomatic pseudoaneurysms. Thus, the purpose of this study was to evaluate the efficacy and safety of carotid artery stenting in treatment of selected pts with extracranial ICAD.

Methods

This study involved 18 symptomatic pts with the mean age of 44.6 ± 10.4 years with ICAD treated with the use of self-expandable stents. Six months after primary procedures, pts were readmitted to hospital and physical examination followed by cerebral angiography was performed. In the late follow-up period, clinical evaluations completed by duplex Doppler ultrasonography were carried out every 6 months and at the end of the follow-up period.

Results

Nobody died and no life-threatening adverse events were observed during either the in-hospital stay or post-discharge follow-up period (median 21 months). Stent deployment immediately restored flow in the true lumen of ICA in all cases. However, residual blood flow through the false lumen was observed in one pt. Complete resolution of clinical symptoms was observed in 14 pts (78 %), partial improvement in 2 (11 %) and persistence of neurological deficit in 2 (11 %).

Conclusions

Implantation of self-expandable stents in treatment of selected extracranial ICAD cases is safe. This method may enable us to restore immediately and usually permanently proper arterial blood flow in the ICA and in consequence lead to significant clinical improvement in the late follow-up period.

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Conflict of interest

Robert Juszkat, Włodzimierz Liebert, Katarzyna Stanisławska, Tomasz Tomczyk, Jarosław Wronka, Norbert Wąsik and Bartłomiej Perek declare that they have no conflict of interest.

Informed Consent

Formal consent of the Local Bioethical Committee was not required for the retrospective clinical study performed in our institution. All individuals provided informed written consent to the use of their demographic and clinical data for scientific purposes.

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Authors and Affiliations

  1. Department of General and Interventional Radiology, Poznań University of Medical Sciences, 1/2 Długa St., 61-848, Poznan, Poland

    Robert Juszkat, Katarzyna Stanisławska & Norbert Wąsik

  2. Department of Neurosurgery, Poznań University of Medical Sciences, 49 Przybyszewskiego St., 60-355, Poznan, Poland

    Robert Juszkat, Włodzimierz Liebert & Katarzyna Stanisławska

  3. Stroke Intensive Care Unit, 7/19 Juraszów St., 60-479, Poznan, Poland

    Tomasz Tomczyk

  4. Department of Neurology, HCP Medical Centre, 194 28 Czerwca 1956 r. St., 61-485, Poznan, Poland

    Jarosław Wronka

  5. Department of Cardiac Surgery and Transplantology, Poznań University of Medical Sciences, 1/2 Długa St., 61-848, Poznan, Poland

    Bartłomiej Perek

Authors
  1. Robert Juszkat
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  2. Włodzimierz Liebert
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  3. Katarzyna Stanisławska
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Correspondence to Bartłomiej Perek.

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Juszkat, R., Liebert, W., Stanisławska, K. et al. Extracranial Internal Carotid Artery Dissection Treated with Self-expandable Stents: A Single-Centre Experience. Cardiovasc Intervent Radiol 38, 1451–1457 (2015). https://doi.org/10.1007/s00270-015-1101-8

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  • DOI: https://doi.org/10.1007/s00270-015-1101-8

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