Cerutti D, Bonafe A, Pelouze G-A, Kassem Z, Filipov R, Runavot G, Cassarini J-F, Sablot D
Service de neurologie, hôpital Saint-Jean, 20, avenue du Languedoc, 66046 Perpignan cedex, France.
Rev Neurol (Paris). 2010 Mar;166(3):333-6. doi: 10.1016/j.neurol.2009.05.019. Epub 2009 Aug 5.
Spontaneous dissection of cervical arteries is one of the major causes of stroke in young patients. The recommended treatment is curative anticoagulation. However, in selected cases, this treatment could fail or meet contraindications. In such cases, an endovascular stent-assisted angioplasty could be successful.
We report the case of a 47-year-old patient with spontaneous dissection of the carotid and vertebral arteries. Despite optimized anticoagulant therapy, cerebral perfusion was low. An endovascular stent-assisted angioplasty was performed in the intra- and extracranial segments of the right internal carotid artery. Consequently by improving the intracranial circulation, normal functioning was restored with no immediate complications and the patient remained free of complications at 16-month follow-up.
Dissections of cervical arteries that lead to a chronic reduction in brain perfusion might benefit from endovascular stent-assisted angioplasty.
颈内动脉自发性夹层是年轻患者中风的主要原因之一。推荐的治疗方法是根治性抗凝治疗。然而，在某些特定情况下，这种治疗可能会失败或出现禁忌证。在这种情况下，血管内支架辅助血管成形术可能会取得成功。
我们报告了一例47岁的患者，其颈动脉和椎动脉发生自发性夹层。尽管进行了优化的抗凝治疗，但脑灌注仍很低。对右侧颈内动脉的颅内和颅外段进行了血管内支架辅助血管成形术。结果，通过改善颅内循环，恢复了正常功能，没有立即出现并发症，并且在16个月的随访中患者没有出现并发症。
导致脑灌注长期降低的颈内动脉夹层可能受益于血管内支架辅助血管成形术。
