Mid-term outcomes of endovascular treatment for internal carotid artery dissection.

IF 1.4 4区医学 Q3 PERIPHERAL VASCULAR DISEASE

International Angiology Pub Date : 2025-08-01 DOI:10.23736/S0392-9590.25.05426-4

Salvatore Bruno, Domenico Mirabella, Ettore Dinoto, Felice Pecoraro

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引用次数: 0

Abstract

Background: This study aims to assess the feasibility and safety of endovascular treatment of spontaneous internal carotid artery dissections (ICAD) using a proximal embolic protection device (EPD).

Methods: From January 2012 to December 2023 all consecutive patients admitted for ICAD who underwent carotid artery stenting using MoMa Ultra (Medtronic, Minneapolis, MN, USA) proximal EPD were included in this single-center study and were retrospectively analyzed. The presence of neurological symptoms was the only indication for treatment. Early outcomes included technical success, perioperative mortality, and major cardiovascular and cerebral complications. Late outcomes were recurrent neurological symptoms, patency, and reinterventions.

Results: A total of 9 patients were included in the study, all presenting with neurological symptoms. Among them, 8 were diagnosed with a transitory ischemic attack (TIA), while 1 had amaurosis fugax and transitory aphasia. Significant haemodinamic ICAD were 7. Complete anatomic resolution was achieved in all patients with no further lesions of the carotid axis. At a median follow-up of 63.9 months (IQR 27.1- 63.3), a single patient died due to worsening of pre-existent chronic heart failure; no intrastent restenosis were registered and all stents were patent.

Conclusions: The use of a proximal EPD for endovascular treatment of ICAD under flow arrest seems to be feasible and safe, minimizing the risk of intraoperative stroke. Larger series are required to confirm these results and validate the treatment strategy.

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血管内治疗颈内动脉夹层中期疗效观察。

背景：本研究旨在评估使用近端栓塞保护装置（EPD）血管内治疗自发性颈内动脉夹层（ICAD）的可行性和安全性。方法：2012年1月至2023年12月，所有连续入院的ICAD患者均采用MoMa Ultra （Medtronic, Minneapolis， MN， USA）近端EPD行颈动脉支架置入，纳入本单中心研究并进行回顾性分析。神经系统症状的出现是治疗的唯一适应症。早期结果包括技术成功、围手术期死亡率和主要的心血管和脑并发症。晚期结果为神经症状复发、通畅和再干预。结果：共纳入9例患者，均表现为神经系统症状。其中短暂性脑缺血发作（TIA） 8例，烟性黑朦、短暂性失语1例。显著血流动力学ICAD为7。所有患者均无颈动脉轴进一步病变，解剖完全解决。中位随访63.9个月（IQR 27.1- 63.3）， 1例患者因既往慢性心力衰竭恶化而死亡；无支架内再狭窄，所有支架均为专利支架。结论：使用近端EPD进行ICAD停搏血管内治疗似乎是可行和安全的，可以最大限度地降低术中卒中的风险。需要更大的系列来证实这些结果并验证治疗策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Angiology 医学-外周血管病

CiteScore

2.80

自引率

28.60%

发文量

审稿时长

6-12 weeks

期刊介绍： International Angiology publishes scientific papers on angiology. Manuscripts may be submitted in the form of editorials, original articles, review articles, special articles, letters to the Editor and guidelines. The journal aims to provide its readers with papers of the highest quality and impact through a process of careful peer review and editorial work. Duties and responsibilities of all the subjects involved in the editorial process are summarized at Publication ethics. Manuscripts are expected to comply with the instructions to authors which conform to the Uniform Requirements for Manuscripts Submitted to Biomedical Editors by the International Committee of Medical Journal Editors (ICMJE).