Single ⁃ center study on endovascular treatment of acute ischemic stroke with large vessel occlusion caused by carotid artery dissection

Abstract

Objective To explore the efficacy and safety of endovascular treatment (EVT) for acute ischemic stroke with large vessel occlusion (AIS ⁃ LVO) caused by carotid artery dissection (CAD). Methods From July 2018 to July 2019, 19 patients with AIS ⁃ LVO caused by CAD, including 11 cases of internal carotid artery (ICA) dissection and 8 cases of vertebral artery (VA) dissection, were treated with EVT (including thrombus aspiration, stent thrombectomy, balloon dilatation and stent implantation). Modified Thrombdy in Cerebral Infarction (mTICI) was to evaluate vascular recanalization, modified Rankin Scale (mRS) was to evaluate the prognosis. Results The forward blood flow of 15 patients recovered to mTICI grade 3 (complete recanalization), and 4 patients recovered to mTICI grade 2b (partial recanalization). Patients with postoperative complications were: one case of death caused by cerebral hernia, one case of cerebral edema due to a large cerebral infarction, one case had a small amount of cerebral hemorrhage, one case of subarachnoid hemorrhage. Seventeen patients had good prognosis at discharge (mRS score ≤ 2), one case had a poor prognosis (mRS score 4), and one case died. Conclusions Patients with AIS ⁃ LVO caused by CAD were assessed and treated with EVT, and the effect of recanalization of occlusive vessels is obvious, and the clinical prognosis is good. DOI：10.3969/j.issn.1672⁃6731.2020.05.009

Keywords

• arterial occlusive diseases
• carotid artery, internal, dissection
• stents
• cerebral angiography