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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
A Journal on Vascular and Endovascular Surgery
Giornale Italiano di Chirurgia Vascolare 2003 March;10(1):67-75
language: English, Italian
Spontaneous carotid artery dissections. Report of 10 cases
Adorni A., Busi N., Adorni An., Sianesi M.
Istituto di Clinica Chirurgica Generale e dei Trapianti d’Organo Università degli Studi di Parma, Parma
Background. The long-term development of carotid dissection was evaluated.
Methods. A retrospective study with a mean follow-up period of 5.5 months (range: 1-10 months) was conducted on 10 patients (8 men, 2 women; mean age: 50 years) admitted on emergency and treated at our unit for acute neurological symptoms. Diagnosis of spontaneous extracranial carotid artery dissection was based on evidence from echo color-Doppler sonography and angiography studies of the supra-aortic trunks. Medical treatment was instituted in 9 patients (5 received only antiplatelet agents, 2 only anticoagulants, 2 combined antiplatelet and anticoagulant therapy, 1 surgical treatment). During the follow-up period, regression of neurological symptoms and development of the lesions were assessed by flowmeter analysis and angiography.
Results. By the end of follow-up, 1 patient treated with antiplatelet therapy alone experienced neurological sequelae despite complete vascular recanalization after 8 months; the 1 patient who underwent surgery developed a complete occlusion after 4 months, with persistence of neurologic deficits. In all the other patients neurologic symptoms resolved.
Conclusions. In agreement with the literature, the data from this small case series support a noninvasive approach to the treatment of this pathology, wherein medical therapy should be prolonged and patients followed up closely.