Endovascular reconstruction of internal carotid artery dissection in patients with acute ischemic stroke using the Wingspan stent

Abstract

Objective

The purpose of this study is to demonstrate our experience in endovascular reconstruction of carotid dissections using the Wingspan Stent System™ (Boston Scientific, Natick, MA, USA), a device we use because of its high radial force and its navigation in extreme curves.

Methods

We treated 11 consecutive patients with acute ischemic stroke due to carotid dissection with the Wingspan stent, in the cervical carotid artery.

Results

Functional evaluation revealed that 10 of the 11 patients were independent at 3 months post surgery and that the 11 stents used were found to be patent at the 6-month follow-up digital subtraction angiography (DSA).

Conclusions

The Wingspan stent is an alternative to classic carotid stents and flow diverters for the treatment of cervical internal carotid artery (ICA) dissection associated with ectasias or large loops. The device remains patent over the long term and it is not associated with arterial wall complications.

Keywords

brain carotid stent carotid dissection internal carotid artery stent stroke Wingspan stent

Get full access to this article

View all access options for this article.

References

Ahlhelm

Benz

Ulmer

. Endovascular treatment of cervical artery dissection: Ten case reports and review of the literature. Interv Neurol 2012; 1: 143–150.

Xianjun

Zhiming

. A systematic review of endovascular management of internal carotid artery dissections. Interv Neurol 2013; 1: 164–170.

Pham

Rahme

Arnaout

. Endovascular stenting of extracranial carotid and vertebral artery dissections: A systematic review of the literature. Neurosurgery 2011; 68: 856–866.

Donas

Mayer

Guber

. Endovascular repair of extracranial carotid artery dissection: Current status and level of evidence. J Vasc Interv Radiol 2008; 19: 1693–1698.

Mourand

Brunel

Vendrell

. Endovascular stent-assisted thrombolysis in acute occlusive carotid artery dissection. Neuroradiology 2010; 52: 135–140.

Lavallée

Mazighi

Saint-Maurice

. Stent-assisted endovascular thrombolysis versus intravenous thrombolysis in internal carotid artery dissection with tandem internal carotid and middle cerebral artery occlusion. Stroke 2007; 38: 2270–2274.

Brzezicki

Rivet

Reavey-Cantwell

. Pipeline embolization device for treatment of high cervical and skull base carotid artery dissections: Clinical case series. J Neurointerv Surg 2015. Jun 18.

Ansari

Thompson

Gemmete

. Endovascular treatment of distal cervical and intracranial dissections with the neuroform stent. Neurosurgery 2008; 62: 636–646.

Juszkat

Liebert

Stanisławska

. Extracranial internal carotid artery dissection treated with self-expandable stents: A single-centre experience. Cardiovasc Intervent Radiol 2015; 38: 1451–1457.

10.

Ohta

Natarajan

Hauck

. Endovascular stent therapy for extracranial and intracranial carotid artery dissection: Single-center experience. J Neurosurg 2011; 115: 91–100.

11.

Krischek

Miloslavski

Fischer

. A comparison of functional and physical properties of self-expanding intracranial stents (Neuroform3, Wingspan, Solitaire, Leo+, Enterprise). Minim Invasive Neurosurg 2011; 54: 21–28.

12.

Powers

Derdeyn

Biller

. Guidelines for the early management of patients with acute ischemic stroke regarding endovascular treatment. Stroke 2015; 46: 3020–3035.