R2-recanalization of spontaneous carotid artery dissection

Nedeltchev, Krassen; Bickel, Stefan; Arnold, Marcel; Sarikaya, Hakan; Georgiadis, Dimitrios; Sturzenegger, Matthias; Mattle, Heinrich P; Baumgartner, Ralf W (2009). R2-recanalization of spontaneous carotid artery dissection. Stroke, 40(2), pp. 499-504. Baltimore, Md.: Lippincott Williams & Wilkins 10.1161/STROKEAHA.108.519694

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BACKGROUND AND PURPOSE: We set out to investigate the predictors and time course for recanalization of spontaneous dissection of the cervical internal carotid artery (SICAD). METHODS: We prospectively included 249 consecutive patients (mean age, 45+/-11 years) with 268 SICAD. Ultrasound examinations were performed at presentation, during the first month, and then at 3, 6, and 12 months, and clinical follow-ups after 3, 6, and 12 months. RESULTS: Of 268 SICADs, 20 (7.5%) presented with <or=50% stenosis, 31 (11.6%) with 51% to 80% stenosis, 92 (34.3%) with 81% to 99% stenosis, and 125 (46.6%) with an occlusion. Antithrombotic treatment included anticoagulation in 174 (67%) patients, aspirin in 64 (24%) patients, and aspirin followed by anticoagulation or vice versa in 22 (8%) patients. Follow-up ultrasound showed normal findings in 160 (60%), <or=50% stenosis in 27 (10%), 51% to 80% stenosis in 4 (1%), 81% to 99% stenosis in 26 (10%), and occlusion in 51 (19%) vessels. The rate of complete recanalization was 16% at 1 month, 50% at 3 months, and 60% at 6 and 12 months. Initial occlusion of the dissected vessels reduced the odds of recanalization (OR, 4.0; 95% CI, 2.2-7.3; P<0.001), whereas the occurrence of local symptoms and signs only at presentation were independently associated with complete recanalization (OR, 0.4; 95% CI, 0.2-0.8; P=0.048). CONCLUSIONS: These results suggest that recanalization of SICAD occurs mainly within the first 6 months after the onset of symptoms. Initial occlusion reduces the likelihood of complete recanalization, whereas presentation with local symptoms and signs only increases it.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Nedeltchev, Krassen; Arnold, Marcel; Sturzenegger, Matthias and Mattle, Heinrich

ISSN:

0039-2499

ISBN:

19109549

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 15:05

Last Modified:

17 Mar 2015 22:20

Publisher DOI:

10.1161/STROKEAHA.108.519694

PubMed ID:

19109549

Web of Science ID:

000262784900026

URI:

https://boris.unibe.ch/id/eprint/28372 (FactScience: 120401)

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