Endovascular Stenting of Vertebral Artery Dissection in Acute Ischemic Stroke
Clinical Neurology and Neuroscience
Volume 3, Issue 4, December 2019, Pages: 74-76
Received: Jul. 1, 2019; Accepted: Aug. 3, 2019; Published: Oct. 11, 2019
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Authors
Mehrnoush Gorjian, Department of Neurosurgery, Massachusetts General Hospital, Boston, USA
Scott B. Raymond, Department of Neurosurgery, Massachusetts General Hospital, Boston, USA
Matthew Koch, Department of Neurosurgery, Massachusetts General Hospital, Boston, USA
Aman B. Patel, Department of Neurosurgery, Massachusetts General Hospital, Boston, USA
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Abstract
Background: Vertebral artery (VA) dissection causing acute stroke is commonly treated with anticoagulation and rarely requires stenting. While stenting for atherosclerotic stenosis of VA is an established and efficient treatment option, the safety of stenting for VA dissection has not been studied. Case information: We report the technical challenges associated with stenting of a proximal VA dissection in a 74 year-old male with NIHSSS > 20 outside of the time window for thrombolytic therapy presenting with acute basilar artery thrombus and a hypoplastic contralateral VA. Methods: A coronary Drug-Eluting Stent (DES) was implemented in right VA following balloon angioplasty and basilar artery thrombolysis to maintain the patency of the dissected area in proximal VA. Results: The procedure was completed without complication. Postoperative Digital Subtraction Angiography (DSA) confirmed the patency of the vertebrobasilar system. There was no evidence of significant residual stenosis in the right vertebral artery on the follow up Computed Tomography Angiography (CTA) 2 months after the stent placement. Conclusion: Endovascular stenting of proximal VA dissection in the setting of acute ischemic stroke is relatively safe and feasible. It could be particularly considered in patients ineligible for IV thrombolysis with a hypoplastic contralateral VA. Further studies are needed to evaluate the long-term safety and efficacy of stenting for VA dissection.
Keywords
Vertebral Artery, Drug-Eluting Stent, Stroke
To cite this article
Mehrnoush Gorjian, Scott B. Raymond, Matthew Koch, Aman B. Patel, Endovascular Stenting of Vertebral Artery Dissection in Acute Ischemic Stroke, Clinical Neurology and Neuroscience. Vol. 3, No. 4, 2019, pp. 74-76. doi: 10.11648/j.cnn.20190304.11
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Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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