Treatment of symptomatic cervical carotid dissections with endovascular stents

OBJECTIVE: Symptomatic dissections of the cervical carotid artery (CCA) can be spontaneous or secondary to trauma and may be associated with pseudoane urysms. Surgical treatment is often difficult or unavailable. We report the successful use of endovascular stents in the treatment of symptomatic diss ection of the CCA. METHODS: Five consecutive patients with symptomatic CCA dissection were see n at our institution. There were four female patients and one male patient, ranging in age from 19 to 56 years. One dissection was spontaneous. The ot hers were secondary to a gunshot wound (one patient), blunt neck trauma (tw o patients), and endovascular treatment of atherosclerotic carotid bifurcat ion disease (one patient). Balloon-expandable and self-expanding stents wer e placed via a transfemoral approach. RESULTS: Success in restoring the carotid lumen with two to five stents in each patient was angiographically demonstrated. There were no procedure-rel ated complications. All patients experienced significant clinical improveme nt within the first 24 hours and complete long-term recovery. CONCLUSION: Symptomatic dissections of the CCA can be successfully treated by using endovascular stents.