Yang Shu, Wang Jian-Hong, Huang Bin, Guo Fu-Qiang, Li Bing-Hu
Department of Neurology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China.
Front Med (Lausanne). 2025 Aug 13;12:1626194. doi: 10.3389/fmed.2025.1626194. eCollection 2025.
Endovascular therapy (EVT) is an effective treatment for large vessel occlusion, including carotid artery dissection (CAD). However, when large vessel occlusion (LVO) occurs in acute ischemic stroke (AIS) patients with concomitant intracranial hemorrhage (ICH), it can be difficult for clinicians to make a treatment decision. We report the case of a patient in their 60s who was admitted due to sudden right limb weakness. Emergency computed tomography (CT)/CTA showed a hematoma in the right parietal lobe and a possible dissection of the left internal carotid artery. The patient underwent emergent carotid artery stenting (eCAS) followed by postoperative tirofiban administration. At six-month follow-up, there was no evidence of new bleeding, clinical function had recovered, and no re-stenosis was observed. For patients with AIS due to CAD complicated by ICH, eCAS combined with tirofiban may offer clinical benefits. However, further research is still needed to confirm our findings.
血管内治疗(EVT)是治疗大血管闭塞的有效方法,包括颈动脉夹层(CAD)。然而,当急性缺血性卒中(AIS)患者发生大血管闭塞(LVO)并伴有颅内出血(ICH)时,临床医生很难做出治疗决策。我们报告了一例60多岁因突发右肢无力入院的患者。急诊计算机断层扫描(CT)/CT血管造影(CTA)显示右侧顶叶有血肿,左侧颈内动脉可能有夹层。该患者接受了急诊颈动脉支架置入术(eCAS),术后给予替罗非班治疗。在六个月的随访中,没有新出血的迹象,临床功能已恢复,且未观察到再狭窄。对于因CAD并发ICH导致AIS的患者,eCAS联合替罗非班可能具有临床益处。然而,仍需要进一步的研究来证实我们的发现。