Oye Herbert, Abbas Nitasha
Endovascular and Vascular Surgery, Raleigh General Hospital, Beckley, USA.
Endovascular and Vascular Surgery, West Virginia Vascular Institute, Beckley, USA.
Cureus. 2024 Feb 21;16(2):e54600. doi: 10.7759/cureus.54600. eCollection 2024 Feb.
Carotid artery dissection (CAD) is a condition that compromises blood flow and leads to serious complications such as a stroke or cerebrovascular accident (CVA). This case report demonstrates an unusual case of right internal carotid artery dissection, stenosis of >70%, and an intraluminal thrombus. The patient presented to the emergency department with complaints of right-sided neck pain and severe headache status-post a complicated pregnancy. A computed tomography (CT) angiogram of the right carotid was conducted and showed a right internal carotid artery dissection with 70% luminal stenosis and thrombosis. Carotid endarterectomy (CEA), transfemoral carotid angioplasty with stenting (CAS), or transcarotid artery revascularization (TCAR) were all surgical intervention options that were explored. Risks and benefits were compared between the three surgical intervention options, and transcarotid artery revascularization was deemed the best surgical option in this patient's case.
颈动脉夹层（CAD）是一种影响血流并导致严重并发症（如中风或脑血管意外[CVA]）的病症。本病例报告展示了一例罕见的右侧颈内动脉夹层、管腔狭窄超过70%并伴有腔内血栓形成的病例。该患者因右侧颈部疼痛和严重头痛就诊于急诊科，其有复杂的妊娠史。对右侧颈动脉进行了计算机断层扫描（CT）血管造影，结果显示右侧颈内动脉夹层伴管腔70%狭窄和血栓形成。颈动脉内膜切除术（CEA）、经股动脉颈动脉血管成形术加支架置入术（CAS）或经颈动脉血管重建术（TCAR）都是探讨过的手术干预选项。对这三种手术干预选项的风险和益处进行了比较，经颈动脉血管重建术被认为是该患者病例中的最佳手术选择。
