BACKGROUND: Endovascular treatment options for internal carotid artery (ICA) dissection with tandem intracranial occlusion are evolving. We report 2 cases of stent reconstruction of carotid loop dissections. METHODS: Two patients with symptomatic ICA dissections of true 360° tonsillar loops and tandem intracranial occlusions were treated with manual aspiration thrombectomy (MAT) and telescoping Zilver self-expanding peripheral stents. Patient demographics, clinical presentations, endovascular techniques, and clinical outcomes were reviewed. RESULTS: In both cases, MAT achieved modified Treatment in Cerebral Ischemia scale 2B reperfusion, and complete endovascular reconstruction of the dissected extracranial loop was performed. Both patients had improved pre- to postintervention National Institutes of Health Stroke Scale scores (16 to 0 and 14 to 0), and both had modified Rankin scale scores of 1 at 3-month follow-up. CONCLUSIONS: Stent reconstruction of complex cerebrovascular anatomy is increasingly feasible with advancements in stent technology and catheter support system design. This technique may be of use to neuroendovascular surgeons who encounter variant ICA anatomy.
BACKGROUND: Endovascular treatment options for internal carotid artery (ICA) dissection with tandem intracranial occlusion are evolving. We report 2 cases of stent reconstruction of carotid loop dissections. METHODS: Two patients with symptomatic ICA dissections of true 360° tonsillar loops and tandem intracranial occlusions were treated with manual aspiration thrombectomy (MAT) and telescoping Zilver self-expanding peripheral stents. Patient demographics, clinical presentations, endovascular techniques, and clinical outcomes were reviewed. RESULTS: In both cases, MAT achieved modified Treatment in Cerebral Ischemia scale 2B reperfusion, and complete endovascular reconstruction of the dissected extracranial loop was performed. Both patients had improved pre- to postintervention National Institutes of Health Stroke Scale scores (16 to 0 and 14 to 0), and both had modified Rankin scale scores of 1 at 3-month follow-up. CONCLUSIONS: Stent reconstruction of complex cerebrovascular anatomy is increasingly feasible with advancements in stent technology and catheter support system design. This technique may be of use to neuroendovascular surgeons who encounter variant ICA anatomy.
Authors: Amer M Malik; Nirav A Vora; Ridwan Lin; Syed F Zaidi; Aitziber Aleu; Brian T Jankowitz; Mouhammad A Jumaa; Vivek K Reddy; Maxim D Hammer; Lawrence R Wechsler; Michael B Horowitz; Tudor G Jovin Journal: Stroke Date: 2011-04-21 Impact factor: 7.914
Authors: Hajime Ohta; Sabareesh K Natarajan; Erik F Hauck; Alexander A Khalessi; Adnan H Siddiqui; L Nelson Hopkins; Elad I Levy Journal: J Neurosurg Date: 2011-03-18 Impact factor: 5.115
Authors: Ajit S Puri; Anna L Kühn; Hyon-Jo Kwon; Muhib Khan; Samuel Y Hou; Eugene Lin; Juyu Chueh; Imramsjah M J van der Bom; Guilherme Dabus; Italo Linfante; Matthew J Gounis; Ajay K Wakhloo Journal: J Neurointerv Surg Date: 2014-02-27 Impact factor: 5.836