Wood Elizabeth C, Marcet Paul A, Fargen Kyle M, Velazquez-Ramirez Gabriela
Department of Vascular and Endovascular Surgery, Wake Forest University School of Medicine, Winston-Salem, NC.
Department of Neurosurgery, Wake Forest University School of Medicine, Winston-Salem, NC.
Ann Vasc Surg. 2025 Apr;113:406-414. doi: 10.1016/j.avsg.2024.06.047. Epub 2024 Sep 27.
Carotid artery dissection is a significant cause of stroke and the leading etiology of ischemic stroke in young and middle-aged individuals. The management of carotid artery dissection is continually evolving and varies based on the patient's clinical presentation. While carotid dissection is typically managed medically, endovascular intervention may be warranted in certain cases, and open surgical intervention is rarely employed. This qualitative review examines contemporary management strategies for cervical carotid artery dissection, highlighting 3 illustrative cases where endovascular intervention was utilized. We present one case of traumatic etiology with acute stroke symptoms, another traumatic case with progressing dissection and pseudoaneurysm evident on imaging, and a case of iatrogenic carotid dissection. Through these cases, we aim to elucidate the decision-making process and outcomes associated with endovascular treatment in the context of carotid artery dissection.
颈动脉夹层是导致中风的重要原因，也是中青年缺血性中风的主要病因。颈动脉夹层的治疗方法不断发展，且因患者的临床表现而异。虽然颈动脉夹层通常采用药物治疗，但在某些情况下可能需要进行血管内介入治疗，而开放手术干预很少使用。本定性综述探讨了颈段颈动脉夹层的当代治疗策略，重点介绍了3例采用血管内介入治疗的典型病例。我们展示了1例有急性中风症状的创伤性病因病例、另1例影像学显示夹层进展和假性动脉瘤的创伤性病例以及1例医源性颈动脉夹层病例。通过这些病例，我们旨在阐明在颈动脉夹层背景下与血管内治疗相关的决策过程和结果。
