Endovascular reconstruction of high cervical and long-segment carotid artery dissections with Leo plus stent,Neuroradiology

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Endovascular reconstruction of high cervical and long-segment carotid artery dissections with Leo plus stent
Neuroradiology ( IF 2.4 ) Pub Date : 2024-01-08 , DOI: 10.1007/s00234-023-03274-y
Guang-Dong Lu ₁ , Wei Yang ₁ , Zhen-Yu Jia ₁ , Sheng Liu ₁

Affiliation

Purpose

Endovascular reconstruction has emerged as a viable alternative for carotid artery dissections (CADs) that are unresponsive to antithrombotic therapy. However, high cervical and long-segment CADs pose challenges during endovascular treatment due to their distal location and tortuous anatomy. We presented our experiences using endovascular reconstruction with the Leo plus stent for this type of CAD.

Methods

We conducted a retrospective review of patients with high cervical and long-segment CADs treated using the Leo plus stent. We analyzed patient demographics, clinical presentations, procedural features, complications, and follow-up outcomes.

Results

A total of 17 patients (mean age, 48.1 years) with 17 CADs were identified. Seven of these dissections were accompanied by pseudoaneurysm. The mean length of the dissection was 5.7 cm, and the mean degree of stenosis was 92.3%. A single Leo plus stent was deployed in 15 patients, while another Wallstent carotid stent was used in 2 cases. All stents were successfully positioned in their intended sites. The average degree of residual stenosis was 22.2%. There were no perioperative complications. With a median follow-up duration of 29 months, no ischemic stroke events occurred. All but one Leo plus stent remained patent during follow-up, and all 7 pseudoaneurysms had disappeared at the last radiological assessment.

Conclusion

Our experience in treating high cervical and long-segment CADs with the Leo plus stent demonstrates that this approach is practical, safe, and effective, as evidenced by long-term observations. The Leo Plus stent appears to be a suitable option for managing this type of CAD.

中文翻译：

Leo plus支架血管内重建高颈长段颈动脉夹层

目的

血管内重建已成为对抗血栓治疗无反应的颈动脉夹层（CAD）的可行替代方案。然而，高颈椎和长节段 CAD 由于其远端位置和曲折的解剖结构，给血管内治疗带来了挑战。我们介绍了使用 Leo plus 支架进行血管内重建治疗此类 CAD 的经验。

方法

我们对使用 Leo plus 支架治疗的高颈椎和长节段 CAD 患者进行了回顾性评价。我们分析了患者人口统计数据、临床表现、手术特征、并发症和随访结果。

结果

总共确定了 17 名患有 17 种 CAD 的患者（平均年龄 48.1 岁）。其中七处夹层伴有假性动脉瘤。夹层平均长度为5.7 cm，平均狭窄程度为92.3%。 15 例患者使用单个 Leo plus 支架，2 例患者使用另一个 Wallstent 颈动脉支架。所有支架均成功放置在预定位置。残余狭窄的平均程度为22.2%。无围手术期并发症。中位随访时间为 29 个月，没有发生缺血性中风事件。在随访期间，除一个 Leo plus 支架外，所有支架均保持通畅，并且在最后一次放射学评估时，所有 7 个假性动脉瘤均已消失。