Endovascular management of symptomatic cerebral malperfusion due to carotid dissection after type A aortic dissection repair

R. Casana, V. Tolva, A. Robecchi Majnardi, P. G. Bianchi, L. Addobati, G. B. Bertoni, L. V. Cireni, V. Silani

Research output: Contribution to journalArticle

Abstract

Purpose: Type A acute aortic dissection is a surgical emergency, and supra-aortic trunk involvement may be complicated by stroke in 6% to 20% of cases. A 66-year-old Caucasian female patient underwent a composite repair of the ascending aorta for type A aortic dissection. Postoperative period was complicated by episodes of "drop attack." Doppler ultrasound of supra-aortic trunks revealed an intimal flap occluding right internal carotid artery. Technique: Multiple stenting was performed from carotid bifurcation to internal carotid artery in order to exclude the dissection intimal flap. After endovascular procedure physiatrist considered that motor functional improvement was better than expected, and we support that endovascular resolution of carotid malperfusion led to a better outcome. Conclusion: According to other experience, endovascular procedure resulted as a safe and effective way. Moreover, ultrasound monitoring of supra-aortic trunks in postoperative period is recommended.

Original languageEnglish
Pages (from-to)641-645
Number of pages5
JournalVascular and Endovascular Surgery
Volume45
Issue number7
DOIs
Publication statusPublished - Oct 2011

Keywords

  • acute aortic syndrome
  • carotid dissection
  • carotid stent
  • carotid ultrasound
  • endovascular surgery
  • stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

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