Endovascular stenting for extracranial internal carotid artery dissection - single-centre experience and literature overview.

Abstract

Purpose: Extracranial internal carotid artery dissections (EICAD) remain a relatively common cause of ischaemic events in young patients. Currently, there is no consensus on standardised use of endovascular therapy in the treatment of these patients, but available data suggest that conservative treatment is not sufficient in 15% of cases. The aim of our study was to evaluate if endovascular stent placement was safe and effective for the treatment of extracranial internal carotid artery dissection, and whether it should be considered in properly selected patients.

Material and methods: This single-centre, retrospective study aimed to evaluate procedural and clinical outcomes of patients with EICAD who underwent endovascular stenting between 2015 and 2024. Procedural and clinical efficacy and safety, the rate of complications, and long-term outcomes were noted.

Results: A total of 21 patients (10 females) with an average age of 53 years underwent stenting for EICAD. Technical success was achieved in all cases. Perioperative complications were noted in 2 cases. Neurological evaluation performed at 6-month follow-up showed very good clinical results in the majority of cases (mRS 0 and mRS 1 were 76% and 19%, respectively). Control imaging examinations confirmed stent patency in all cases. No long-term mortality was observed.

Conclusions: This retrospective study demonstrated procedural and clinical safety and efficacy of endovascular stenting in patients with extracranial internal carotid artery dissection. That is why endovascular therapy should be proposed to individuals with unsatisfactory response to medical treatment and in cases of disease progression.