Clinical characteristics, treatments and prognoses of carotid artery dissection
10.3760/cma.j.cn115354-20240809-00471
- VernacularTitle:颈动脉夹层的临床特点、治疗方式及预后分析
- Author:
Yanwei YIN
1
;
Guangyun ZHANG
1
;
Dawei CHEN
1
;
Jin SHI
1
;
Yiyao ZHANG
1
;
Ying ZHANG
1
;
Fen YANG
1
Author Information
1. 中国人民解放军空军特色医学中心神经内科，北京 100142
- Publication Type:Journal Article
- Keywords:
Carotid artery dissection;
Medicine therapy;
Endovascular therapy
- From:
Chinese Journal of Neuromedicine
2025;24(1):60-64
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical characteristics, treatments and prognoses of carotid artery dissection (CAD).Methods:Nine patients with CAD, admitted to Department of Neurology, Air Force Medical Center of PLA from May 2010 to April 2024, were chosen; the clinical and imaging data, treatments and prognoses (mRS score≤2: good prognosis) of the patients were retrospectively analyzed.Results:(1) Among the 9 patients with CAD, histories of hypertension, diabetes, head and neck trauma, and radiotherapy were noted 3, 2, 4 and 1 patients, respectively; and unclear past history was noted in 1 patient. Carotid ultrasound was performed in 9 patients: slow blood flow of the internal carotid artery with stenosis or occlusion in 7 patients and normal blood flow of the internal carotid artery in 2 patients were noted. MRA in 5 patients showed severe stenosis or subtotal occlusion in the internal carotid artery. DSA in 8 patients showed CAD plus severe stenosis or subtotal occlusion. (2) After ineffective antiplatelet therapy in 3 patients and ineffective anticoagulant therapy in 2 patients, carotid artery stenting (CAS) was performed; direct CAS was given in one patient, and anticoagulant therapy was given in 3 patients. (3) After 3 months of treatment, 9 patients had a good prognosis; carotid ultrasound in 4 patients showed vascular recanalization; MRA re-examination in 3 patients showed vascular recanalization. DSA re-examination in 1 patient showed vascular recanalization; CTA re-examination in 1 patient showed moderate stenosis of the right internal carotid artery.Conclusion:CAD causes are various; CAD should be considered in patients with neck trauma combined with stroke; endovascular treatment should be considered when antiplatelet/anticoagulant therapy are not effective.
