Successful carotid artery stenting in patients with aortic dissection
1Department of Neurology, Chosun University School of Medicine, 61453 Gwangju, South Korea
2Department of Neurosurgery, Chosun University School of Medicine, 61453 Gwangju, South Korea
3Department of Neurology, Jeonbuk National University School of Medicine, 54907 Jeonju, South Korea
Online publish date: 12 November 2020
† These authors contributed equally.
Background: There are no guidelines for the optimal timing of surgery (emergency vs. delayed) for ascending aortic dissection with acute ischemic stroke. We retrospectively compared the prognoses and radiological and clinical findings for concomitant aortic dissection and ischemic stroke in a series of case reports. Case presentation: Three patients presented with left hemiparesis. Patient 1 underwent surgery for acute aortic dissection without treatment for acute ischemic stroke. In Patient 2, emergency stenting could not be performed due to cardiac tamponade and hypotension. Therefore, emergency acute aortic dissection surgery was performed. Patient 3 underwent emergency right common carotid artery stenting followed by surgery for acute aortic dissection. Brain perfusion computed tomography angiography (CTA) was performed to diagnose severe stenosis of the right common carotid artery or occlusion concomitant with acute aortic dissection involving the aortic arch with a cerebral perfusion mismatch in all the patients. Patient 3 had postoperative local cerebral infarction, whereas patients 1 and 2 (without stent insertion) had extensive postoperative cerebral infarction. Conclusion: Patient 3 showed a better prognosis than patients without stent treatment. We suggest that perfusion CTA of the aortic arch in suspected acute ischemic stroke can facilitate early diagnosis and prompt treatment in similar patients.
Acute stroke; Aortic arch; Aortic dissection; Common carotid artery; Stent
Pahn-Kyu Choi,Sang-Woo Ha,Byoung-Soo Shin,Hyun-Goo Kang. Successful carotid artery stenting in patients with aortic dissection. Signa Vitae. 2020.doi:10.22514/sv.2020.16.0089.
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