首发72小时后双侧自发性颈内动脉夹层伴低灌注的一期支架植入术：病例报告
Primary stent implantation for bilateral spontaneous cervical ICA dissections with hypoperfusion after 72 h from onset: a case report.
作者信息
Chen Yijie, Zhang Ningyuan, Chen Yigang, Zheng Xu, Jin Xing, Zhang Jinhua
机构信息
Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No.3, East Qingchun Road, Hangzhou, China.
Department of Neurology, the First Hospital of Tongxiang, Jiaochang Road 1918, Tongxiang, Zhejiang, China.
出版信息
CVIR Endovasc. 2022 Aug 13;5(1):40. doi: 10.1186/s42155-022-00318-x.
BACKGROUND
Spontaneous cervical internal carotid artery dissection (cICAD) is a common cause of stroke in young adults. Endovascular therapy is an indispensable treatment for cICAD in some cases, but it faces great challenges.
CASE PRESENTATION
A bilateral spontaneous cICADs with hypoperfusion-related AIS after 72 h from the onset was presented herein. The patient responded well to primary Solitaire stent detachment at the critical flow-limiting site.
CONCLUSIONS
Primary stent implantation at the critical flow-limiting site rather than covering the entire dissection may be a therapeutic option in spontaneous cICAD complicated with cerebral hypoperfusion. The Solitaire stent may be a good choice at the acute and subacute stages of cICAD.
背景
自发性颈内动脉夹层（cICAD）是年轻成年人中风的常见原因。血管内治疗在某些情况下是cICAD不可或缺的治疗方法，但面临巨大挑战。
病例报告
本文介绍了一例发病72小时后出现双侧自发性cICADs并伴有低灌注相关急性缺血性卒中（AIS）的病例。患者在关键的血流限制部位进行初次Solitaire支架取栓后反应良好。
结论
在关键的血流限制部位进行初次支架植入而非覆盖整个夹层，可能是自发性cICAD合并脑低灌注的一种治疗选择。Solitaire支架可能是cICAD急性和亚急性阶段的良好选择。
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