Background: Vertebral artery (VA) dissection causing acute stroke is commonly treated with anticoagulation and rarely requires stenting. While stenting for atherosclerotic stenosis of VA is an established and efficient treatment option, the safety of stenting for VA dissection has not been studied. Case information: We report the technical challenges associated with stenting of a proximal VA dissection in a 74 year-old male with NIHSSS > 20 outside of the time window for thrombolytic therapy presenting with acute basilar artery thrombus and a hypoplastic contralateral VA. Methods: A coronary Drug-Eluting Stent (DES) was implemented in right VA following balloon angioplasty and basilar artery thrombolysis to maintain the patency of the dissected area in proximal VA. Results: The procedure was completed without complication. Postoperative Digital Subtraction Angiography (DSA) confirmed the patency of the vertebrobasilar system. There was no evidence of significant residual stenosis in the right vertebral artery on the follow up Computed Tomography Angiography (CTA) 2 months after the stent placement. Conclusion: Endovascular stenting of proximal VA dissection in the setting of acute ischemic stroke is relatively safe and feasible. It could be particularly considered in patients ineligible for IV thrombolysis with a hypoplastic contralateral VA. Further studies are needed to evaluate the long-term safety and efficacy of stenting for VA dissection.
| Published in | Clinical Neurology and Neuroscience (Volume 3, Issue 4) |
| DOI | 10.11648/j.cnn.20190304.11 |
| Page(s) | 74-76 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2019. Published by Science Publishing Group |
Vertebral Artery, Drug-Eluting Stent, Stroke
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APA Style
Mehrnoush Gorjian, Scott B. Raymond, Matthew Koch, Aman B. Patel. (2019). Endovascular Stenting of Vertebral Artery Dissection in Acute Ischemic Stroke. Clinical Neurology and Neuroscience, 3(4), 74-76. https://doi.org/10.11648/j.cnn.20190304.11
ACS Style
Mehrnoush Gorjian; Scott B. Raymond; Matthew Koch; Aman B. Patel. Endovascular Stenting of Vertebral Artery Dissection in Acute Ischemic Stroke. Clin. Neurol. Neurosci. 2019, 3(4), 74-76. doi: 10.11648/j.cnn.20190304.11
AMA Style
Mehrnoush Gorjian, Scott B. Raymond, Matthew Koch, Aman B. Patel. Endovascular Stenting of Vertebral Artery Dissection in Acute Ischemic Stroke. Clin Neurol Neurosci. 2019;3(4):74-76. doi: 10.11648/j.cnn.20190304.11
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Download@article{10.11648/j.cnn.20190304.11,
author = {Mehrnoush Gorjian and Scott B. Raymond and Matthew Koch and Aman B. Patel},
title = {Endovascular Stenting of Vertebral Artery Dissection in Acute Ischemic Stroke},
journal = {Clinical Neurology and Neuroscience},
volume = {3},
number = {4},
pages = {74-76},
doi = {10.11648/j.cnn.20190304.11},
url = {https://doi.org/10.11648/j.cnn.20190304.11},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cnn.20190304.11},
abstract = {Background: Vertebral artery (VA) dissection causing acute stroke is commonly treated with anticoagulation and rarely requires stenting. While stenting for atherosclerotic stenosis of VA is an established and efficient treatment option, the safety of stenting for VA dissection has not been studied. Case information: We report the technical challenges associated with stenting of a proximal VA dissection in a 74 year-old male with NIHSSS > 20 outside of the time window for thrombolytic therapy presenting with acute basilar artery thrombus and a hypoplastic contralateral VA. Methods: A coronary Drug-Eluting Stent (DES) was implemented in right VA following balloon angioplasty and basilar artery thrombolysis to maintain the patency of the dissected area in proximal VA. Results: The procedure was completed without complication. Postoperative Digital Subtraction Angiography (DSA) confirmed the patency of the vertebrobasilar system. There was no evidence of significant residual stenosis in the right vertebral artery on the follow up Computed Tomography Angiography (CTA) 2 months after the stent placement. Conclusion: Endovascular stenting of proximal VA dissection in the setting of acute ischemic stroke is relatively safe and feasible. It could be particularly considered in patients ineligible for IV thrombolysis with a hypoplastic contralateral VA. Further studies are needed to evaluate the long-term safety and efficacy of stenting for VA dissection.},
year = {2019}
}
TY - JOUR T1 - Endovascular Stenting of Vertebral Artery Dissection in Acute Ischemic Stroke AU - Mehrnoush Gorjian AU - Scott B. Raymond AU - Matthew Koch AU - Aman B. Patel Y1 - 2019/10/11 PY - 2019 N1 - https://doi.org/10.11648/j.cnn.20190304.11 DO - 10.11648/j.cnn.20190304.11 T2 - Clinical Neurology and Neuroscience JF - Clinical Neurology and Neuroscience JO - Clinical Neurology and Neuroscience SP - 74 EP - 76 PB - Science Publishing Group SN - 2578-8930 UR - https://doi.org/10.11648/j.cnn.20190304.11 AB - Background: Vertebral artery (VA) dissection causing acute stroke is commonly treated with anticoagulation and rarely requires stenting. While stenting for atherosclerotic stenosis of VA is an established and efficient treatment option, the safety of stenting for VA dissection has not been studied. Case information: We report the technical challenges associated with stenting of a proximal VA dissection in a 74 year-old male with NIHSSS > 20 outside of the time window for thrombolytic therapy presenting with acute basilar artery thrombus and a hypoplastic contralateral VA. Methods: A coronary Drug-Eluting Stent (DES) was implemented in right VA following balloon angioplasty and basilar artery thrombolysis to maintain the patency of the dissected area in proximal VA. Results: The procedure was completed without complication. Postoperative Digital Subtraction Angiography (DSA) confirmed the patency of the vertebrobasilar system. There was no evidence of significant residual stenosis in the right vertebral artery on the follow up Computed Tomography Angiography (CTA) 2 months after the stent placement. Conclusion: Endovascular stenting of proximal VA dissection in the setting of acute ischemic stroke is relatively safe and feasible. It could be particularly considered in patients ineligible for IV thrombolysis with a hypoplastic contralateral VA. Further studies are needed to evaluate the long-term safety and efficacy of stenting for VA dissection. VL - 3 IS - 4 ER -
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