Primary stent implantation for bilateral spontaneous cervical ICA dissections with hypoperfusion after 72 h from onset: a case report

Yijie Chen; Ningyuan Zhang; Yigang Chen; Xu Zheng; Xing Jin; Jinhua Zhang

doi:10.1186/s42155-022-00318-x

Primary stent implantation for bilateral spontaneous cervical ICA dissections with hypoperfusion after 72 h from onset: a case report

CVIR Endovasc. 2022 Aug 13;5(1):40. doi: 10.1186/s42155-022-00318-x.

Authors

Yijie Chen^#¹, Ningyuan Zhang^#², Yigang Chen¹, Xu Zheng¹, Xing Jin¹, Jinhua Zhang³

Affiliations

¹ Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No.3, East Qingchun Road, Hangzhou, China.
² Department of Neurology, the First Hospital of Tongxiang, Jiaochang Road 1918, Tongxiang, Zhejiang, China.
³ Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No.3, East Qingchun Road, Hangzhou, China. zhangjinhua@zju.edu.cn.

^# Contributed equally.

Abstract

Background: Spontaneous cervical internal carotid artery dissection (cICAD) is a common cause of stroke in young adults. Endovascular therapy is an indispensable treatment for cICAD in some cases, but it faces great challenges.

Case presentation: A bilateral spontaneous cICADs with hypoperfusion-related AIS after 72 h from the onset was presented herein. The patient responded well to primary Solitaire stent detachment at the critical flow-limiting site.

Conclusions: Primary stent implantation at the critical flow-limiting site rather than covering the entire dissection may be a therapeutic option in spontaneous cICAD complicated with cerebral hypoperfusion. The Solitaire stent may be a good choice at the acute and subacute stages of cICAD.

Keywords: Acute ischemic stroke; Endovascular treatment; Internal carotid artery; Spontaneous dissection; Stenting.