Published Online
on March 3, 2005

A more recent version of this article appeared on April 1, 2005

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Submitted on November 7, 2004
Revised on December 20, 2004
Accepted on January 3, 2005

Endovascular Stent-Assisted Angioplasty in the Management of Traumatic Internal Carotid Artery Dissections

José E. Cohen MD^*; Tamir Ben-Hur MD, PhD; Gustavo Rajz MD; Felix Umansky MD; and John M. Gomori

From the Departments of Neurosurgery (J.E.C., F.U.), Division of Neuroendovascular Surgery and Interventional Neuroradiology (J.E.C., M.G.), and Neurology (T.B.H.), Hadassah-Hebrew University Medical Center, Jerusalem, Israel.

^* To whom correspondence should be addressed. E-mail: jcohenns{at}yahoo.com.

Background and Purpose--The prognosis of traumatic dissection of the internal carotid artery is worse than for spontaneous dissections. Rapid stenting followed by antiplatelet therapy may prevent complications when anticoagulation therapy is not applicable.

Methods--Patients with angiographically proven traumatic carotid artery dissection and hemodynamic significant hemispheric hypoperfusion, or in whom anticoagulant therapy was either contraindicated or failed clinically, were regarded as being at high risk for stroke and were selected for stenting.

Results--Ten patients with traumatic dissection underwent stenting. Endovascular treatment reduced mean dissection stenosis from 69% to 8%. During a mean clinical follow-up time of 16 months, none had additional transient ischemic attacks or stroke. Doppler ultrasound studies did not detect any signs of de novo in-stent stenosis.

Conclusion--In selected cases of traumatic carotid artery dissections, endovascular stent-assisted angioplasty immediately restored the integrity of the vessel lumen and prevented efficiently the occurrence of new ischemic events, without additional anticoagulation.

Key words: carotid arteries • stents • stroke, ischemic • trauma

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