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Mechanical recanalization of acute carotid terminus occlusion from traumatic arterial dissection.

Chen M - Front Neurol (2010)

Bottom Line: In the setting of an acute stroke caused by arterial dissection, navigating a microcatheter and microguidewire past the dissected artery to gain access to the distal thromboembolic lesion may exacerbate the underlying pathology.We review a case report whereby successful recanalization of an acute carotid terminus occlusion due to intimal-media dissection in the cervical carotid artery emphasizing the importance of aggressive proximal guide catheter aspiration in conjunction with flow arrest from the carotid bulb proximal to the dissection.We discuss the strengths and limitations of this approach and underscore the importance of a pathology-based approach to acute stroke therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurological Sciences, Rush University Medical Center Chicago, IL, USA.

ABSTRACT
In the setting of an acute stroke caused by arterial dissection, navigating a microcatheter and microguidewire past the dissected artery to gain access to the distal thromboembolic lesion may exacerbate the underlying pathology. We review a case report whereby successful recanalization of an acute carotid terminus occlusion due to intimal-media dissection in the cervical carotid artery emphasizing the importance of aggressive proximal guide catheter aspiration in conjunction with flow arrest from the carotid bulb proximal to the dissection. We discuss the strengths and limitations of this approach and underscore the importance of a pathology-based approach to acute stroke therapy.

No MeSH data available.


Related in: MedlinePlus

Diffusion weighted MRI showing increased signal in a superior division middle cerebral artery branch territory.
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Related In: Results  -  Collection

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Figure 6: Diffusion weighted MRI showing increased signal in a superior division middle cerebral artery branch territory.

Mentions: MRI and MRA of the head and neck was done the following day, showing a stable appearance to the dissection and a right superior division MCA territory stroke (Figure 6). He was discharged from the hospital 5 days later with an NIHSS of 1. Six weeks later, his NIHSS score remained 1 with slight word finding difficulties and MRA showed persistence of the right cervical/petrous dissection. He was maintained on anticoagulation for 6 months and on 12 month followup, his NIHSS score was 0 and he was back to work in construction.


Mechanical recanalization of acute carotid terminus occlusion from traumatic arterial dissection.

Chen M - Front Neurol (2010)

Diffusion weighted MRI showing increased signal in a superior division middle cerebral artery branch territory.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3008916&req=5

Figure 6: Diffusion weighted MRI showing increased signal in a superior division middle cerebral artery branch territory.
Mentions: MRI and MRA of the head and neck was done the following day, showing a stable appearance to the dissection and a right superior division MCA territory stroke (Figure 6). He was discharged from the hospital 5 days later with an NIHSS of 1. Six weeks later, his NIHSS score remained 1 with slight word finding difficulties and MRA showed persistence of the right cervical/petrous dissection. He was maintained on anticoagulation for 6 months and on 12 month followup, his NIHSS score was 0 and he was back to work in construction.

Bottom Line: In the setting of an acute stroke caused by arterial dissection, navigating a microcatheter and microguidewire past the dissected artery to gain access to the distal thromboembolic lesion may exacerbate the underlying pathology.We review a case report whereby successful recanalization of an acute carotid terminus occlusion due to intimal-media dissection in the cervical carotid artery emphasizing the importance of aggressive proximal guide catheter aspiration in conjunction with flow arrest from the carotid bulb proximal to the dissection.We discuss the strengths and limitations of this approach and underscore the importance of a pathology-based approach to acute stroke therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurological Sciences, Rush University Medical Center Chicago, IL, USA.

ABSTRACT
In the setting of an acute stroke caused by arterial dissection, navigating a microcatheter and microguidewire past the dissected artery to gain access to the distal thromboembolic lesion may exacerbate the underlying pathology. We review a case report whereby successful recanalization of an acute carotid terminus occlusion due to intimal-media dissection in the cervical carotid artery emphasizing the importance of aggressive proximal guide catheter aspiration in conjunction with flow arrest from the carotid bulb proximal to the dissection. We discuss the strengths and limitations of this approach and underscore the importance of a pathology-based approach to acute stroke therapy.

No MeSH data available.


Related in: MedlinePlus