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Urgent Carotid Artery Stenting with Intracranial and Carotid Stent for Symptomatic Bilateral Consecutive Internal Carotid Artery Dissection: A Case Report
Spontaneous internal carotid artery dissection (CAD) is a relatively rare disease, with patients, including those with bilateral CAD, often recovering after conservative therapy. However, patients with symptomatic and progressive disease require urgent carotid artery stenting (CAS). If CAD extends t...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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The Japan Neurosurgical Society
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9704847/ https://www.ncbi.nlm.nih.gov/pubmed/36474502 http://dx.doi.org/10.2176/jns-nmc.2022-0173 |
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author | TAKANO, Yuki ISHIKAWA, Tatsuya FUNATSU, Takayuki EGUCHI, Seiichiro SUMI, Masatake YAMAGUCHI, Koji KAWAMATA, Takakazu |
author_facet | TAKANO, Yuki ISHIKAWA, Tatsuya FUNATSU, Takayuki EGUCHI, Seiichiro SUMI, Masatake YAMAGUCHI, Koji KAWAMATA, Takakazu |
author_sort | TAKANO, Yuki |
collection | PubMed |
description | Spontaneous internal carotid artery dissection (CAD) is a relatively rare disease, with patients, including those with bilateral CAD, often recovering after conservative therapy. However, patients with symptomatic and progressive disease require urgent carotid artery stenting (CAS). If CAD extends to the petrous portion of the internal carotid artery (ICA), it is difficult to treat with a carotid stent alone. This report describes a rare case of consecutive spontaneous bilateral CAD that required an intracranial stent with an interval of 4 years between the first and second CAS. A 58-year-old man with a history of dyslipidemia was admitted for transient ischemic attacks. He underwent CAS with carotid and intracranial stents on the third day for the left CAD due to exacerbation of symptoms under antithrombotic therapy and new stroke on magnetic resonance imaging (MRI). He recovered well. However, 4 years after the initial treatment, the patient was admitted again because of a sudden headache, photophobia, and transient weakness of the left lower limb. He was diagnosed with CAD on the contralateral side. He underwent CAS with carotid and intracranial stents due to progressive neurological deterioration under antithrombotic therapy. After treatment, he was clinically stable without any new infarctions on a follow-up MRI. He was discharged without neurological deficit. Our case of bilateral internal CAD treatment demonstrated that early revascularization with immediate stenting with carotid and intracranial stents in CAD contributes to the prevention of extensive neurological damage, thereby providing a favorable outcome in some cases. |
format | Online Article Text |
id | pubmed-9704847 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | The Japan Neurosurgical Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-97048472022-12-05 Urgent Carotid Artery Stenting with Intracranial and Carotid Stent for Symptomatic Bilateral Consecutive Internal Carotid Artery Dissection: A Case Report TAKANO, Yuki ISHIKAWA, Tatsuya FUNATSU, Takayuki EGUCHI, Seiichiro SUMI, Masatake YAMAGUCHI, Koji KAWAMATA, Takakazu NMC Case Rep J Case Report Spontaneous internal carotid artery dissection (CAD) is a relatively rare disease, with patients, including those with bilateral CAD, often recovering after conservative therapy. However, patients with symptomatic and progressive disease require urgent carotid artery stenting (CAS). If CAD extends to the petrous portion of the internal carotid artery (ICA), it is difficult to treat with a carotid stent alone. This report describes a rare case of consecutive spontaneous bilateral CAD that required an intracranial stent with an interval of 4 years between the first and second CAS. A 58-year-old man with a history of dyslipidemia was admitted for transient ischemic attacks. He underwent CAS with carotid and intracranial stents on the third day for the left CAD due to exacerbation of symptoms under antithrombotic therapy and new stroke on magnetic resonance imaging (MRI). He recovered well. However, 4 years after the initial treatment, the patient was admitted again because of a sudden headache, photophobia, and transient weakness of the left lower limb. He was diagnosed with CAD on the contralateral side. He underwent CAS with carotid and intracranial stents due to progressive neurological deterioration under antithrombotic therapy. After treatment, he was clinically stable without any new infarctions on a follow-up MRI. He was discharged without neurological deficit. Our case of bilateral internal CAD treatment demonstrated that early revascularization with immediate stenting with carotid and intracranial stents in CAD contributes to the prevention of extensive neurological damage, thereby providing a favorable outcome in some cases. The Japan Neurosurgical Society 2022-11-09 /pmc/articles/PMC9704847/ /pubmed/36474502 http://dx.doi.org/10.2176/jns-nmc.2022-0173 Text en © 2022 The Japan Neurosurgical Society https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives International License. |
spellingShingle | Case Report TAKANO, Yuki ISHIKAWA, Tatsuya FUNATSU, Takayuki EGUCHI, Seiichiro SUMI, Masatake YAMAGUCHI, Koji KAWAMATA, Takakazu Urgent Carotid Artery Stenting with Intracranial and Carotid Stent for Symptomatic Bilateral Consecutive Internal Carotid Artery Dissection: A Case Report |
title | Urgent Carotid Artery Stenting with Intracranial and Carotid Stent for Symptomatic Bilateral Consecutive Internal Carotid Artery Dissection: A Case Report |
title_full | Urgent Carotid Artery Stenting with Intracranial and Carotid Stent for Symptomatic Bilateral Consecutive Internal Carotid Artery Dissection: A Case Report |
title_fullStr | Urgent Carotid Artery Stenting with Intracranial and Carotid Stent for Symptomatic Bilateral Consecutive Internal Carotid Artery Dissection: A Case Report |
title_full_unstemmed | Urgent Carotid Artery Stenting with Intracranial and Carotid Stent for Symptomatic Bilateral Consecutive Internal Carotid Artery Dissection: A Case Report |
title_short | Urgent Carotid Artery Stenting with Intracranial and Carotid Stent for Symptomatic Bilateral Consecutive Internal Carotid Artery Dissection: A Case Report |
title_sort | urgent carotid artery stenting with intracranial and carotid stent for symptomatic bilateral consecutive internal carotid artery dissection: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9704847/ https://www.ncbi.nlm.nih.gov/pubmed/36474502 http://dx.doi.org/10.2176/jns-nmc.2022-0173 |
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