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Case Report

Open Access

Successful carotid artery stenting in patients with aortic dissection

  • Pahn-Kyu Choi1,†
  • Sang-Woo Ha2,†
  • Byoung-Soo Shin3
  • Hyun-Goo Kang3

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

DOI: 10.22514/sv.2020.16.0089

Online publish date: 12 November 2020

*Corresponding Author(s): Hyun-Goo Kang E-mail: hgkang@jbnu.ac.kr

† These authors contributed equally.

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Abstract

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.

Key words

Acute stroke; Aortic arch; Aortic dissection; Common carotid artery; Stent

Cite And Share

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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