Endovascular repair of an acute symptomatic carotid artery dissection through the false dissecting carotid lumen.

Journal Article (Journal Article)

A 48-year-old woman presented with an acute ischemic stroke (National Institutes of Health Stroke Scale (NIHSS) 21) six hours after symptom onset. Workup revealed a left cervical internal carotid artery (ICA) occlusive dissection, which was emergently reconstructed with a flow-diverting stent. A routine Duplex scan one hour later suggested reocclusion of the ICA, confirmed by angiography. The true lumen of the ICA could not be accessed and therefore the "false lumen" of the ICA dissection was entered proximally. The true lumen and ultimately the flow-diverting stent were accessed via the false lumen. In analogy to the subintimal arterial flossing with antegrade-retrograde intervention technique described for peripheral vascular disease, several stents were placed in telescoping fashion from the true common carotid lumen through the "false dissecting" lumen of the proximal ICA into the distal true lumen. The stent construct remained patent, and the patient recovered clinically to an NIHSS of 1.

Full Text

Duke Authors

Cited Authors

  • Befera, N; Griffin, AS; Hauck, EF

Published Date

  • February 2019

Published In

Volume / Issue

  • 25 / 1

Start / End Page

  • 51 - 53

PubMed ID

  • 30189757

Pubmed Central ID

  • PMC6378529

Electronic International Standard Serial Number (EISSN)

  • 2385-2011

Digital Object Identifier (DOI)

  • 10.1177/1591019918798154

Language

  • eng

Conference Location

  • United States