Jeong Hye Seon, Jeong Eun-Oh, Lee In Young, Lee Hak In, Koh Hyeon-Song, Kwon Hyon-Jo
Department of Neurology, Daejeon-Chungnam Regional Cerebrovascular Center, Chungnam National University Hospital, Daejeon, Korea.
Department of Neurosurgery, Daejeon-Chungnam Regional Cerebrovascular Center, Chungnam National University Hospital, Daejeon, Korea.
J Cerebrovasc Endovasc Neurosurg. 2023 Sep;25(3):333-339. doi: 10.7461/jcen.2022.E2022.06.011. Epub 2022 Dec 19.
Aortic dissection is one of the causes of acute ischemic stroke. Endovascular recanalization therapy (EVT) has emerged as an essential treatment for acute ischemic stroke due to large artery occlusion. However, it is rarely performed in the situation of hidden aortic dissection (AD). Two patients presented to the emergency room with focal neurologic deficits. The first patient was diagnosed with right internal carotid artery (ICA) occlusion. Angiography revealed that the ICA was occluded by the dissection flap. After a stent deployment in the proximal ICA, the antegrade flow was restored. The patient was diagnosed with AD on chest computed tomography (CT) after EVT. For the second patient, intraarterial thrombectomy was performed to treat left middle cerebral artery occlusion. AD was first detected on echocardiography, which was performed after EVT. Herein, we report successful endovascular recanalization therapy performed in two patients with acute ischemic stroke in the situation of undiagnosed aortic dissection. We also reviewed previous case reports and relevant literature.
主动脉夹层是急性缺血性卒中的病因之一。血管内再通治疗（EVT）已成为治疗大动脉闭塞所致急性缺血性卒中的重要手段。然而，在隐匿性主动脉夹层（AD）情况下很少进行该治疗。两名出现局灶性神经功能缺损的患者被送往急诊室。首例患者被诊断为右侧颈内动脉（ICA）闭塞。血管造影显示ICA被夹层瓣阻塞。在ICA近端置入支架后，血流恢复正常。该患者在接受EVT后经胸部计算机断层扫描（CT）诊断为AD。第二例患者接受了动脉内血栓切除术以治疗左大脑中动脉闭塞。在接受EVT后进行的超声心动图检查首次发现了AD。在此，我们报告了在未诊断出主动脉夹层的情况下，对两名急性缺血性卒中患者成功实施血管内再通治疗的病例。我们还回顾了既往病例报告和相关文献。
