Skip to main content

Acute Stroke Thrombectomy and Emergent Management of Tandem Cervical Dissections

  • Chapter
  • First Online:
12 Strokes

Abstract

Dissections are an uncommon but important cause of acute ischemic stroke, often resulting in both a proximal flow-limiting lesion as well as an intracranial embolic occlusion. Strategies for treatment and management are described.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Ansari SA, Parmar H, Ibrhaim M, et al. Cervical dissections: diagnosis, management, and endovascular treatment. Neuroimaging Clin N Am. 2009;19:257–70.

    Article  Google Scholar 

  2. Hoving JW, Marquering HA, Majoie CBLM. Endovascular treatment in patients with carotid artery dissection and intracranial occlusion: a systematic review. Neuroradiology. 2017;59:641–7.

    Article  Google Scholar 

  3. Stampfl S, Ringleb PA, Mohlenbruch M, et al. Emergency cervical internal carotid artery stenting in combination with intracranial thrombectomy in acute stroke. Am J Neuroradiol. 2014;35:741–6.

    Article  CAS  Google Scholar 

  4. Ansari SA, Kuhn AL, Honarmand AR, et al. Emergent endovascular management of long-segment and flow-limiting carotid artery dissections in acute ischemic stroke intervention with multiple tandem stents. Am J Neuroradiol. 2017;38:97–104.

    Article  CAS  Google Scholar 

  5. Marnat G, Mourand I, Eker O, Machi P, Arquizan C, Riquelme C, Ayrignac X, Bonafé A, Costalat V. Endovascular management of tandem occlusion stroke related to internal carotid artery dissection using a distal to proximal approach: insight from the RECOST study. AJNR Am J Neuroradiol. 2016;37(7):1281–8.

    Article  CAS  Google Scholar 

  6. Goyal M, Menon BK, van Zwam WH, Dippel DW, Mitchell PJ, Demchuk AM, Dávalos A, Majoie CB, van der Lugt A, de Miquel MA, Donnan GA, Roos YB, Bonafe A, Jahan R, Diener HC, van den Berg LA, Levy EI, Berkhemer OA, Pereira VM, Rempel J, Millán M, Davis SM, Roy D, Thornton J, Román LS, Ribó M, Beumer D, Stouch B, Brown S, Campbell BC, van Oostenbrugge RJ, Saver JL, Hill MD, Jovin TG, HERMES Collaborators. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet. 2016;387(10029):1723–31.

    Article  Google Scholar 

  7. Albers GW, Marks MP, Kemp S, Christensen S, Tsai JP, Ortega-Gutierrez S, McTaggart RA, Torbey MT, Kim-Tenser M, Leslie-Mazwi T, Sarraj A, Kasner SE, Ansari SA, Yeatts SD, Hamilton S, Mlynash M, Heit JJ, Zaharchuk G, Kim S, Carrozzella J, Palesch YY, Demchuk AM, Bammer R, Lavori PW, Broderick JP, Lansberg MG, DEFUSE 3 Investigators. Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging. N Engl J Med. 2018;378(8):708–18.

    Article  Google Scholar 

  8. Nogueira RG, Jadhav AP, Haussen DC, Bonafe A, Budzik RF, Bhuva P, Yavagal DR, Ribo M, Cognard C, Hanel RA, Sila CA, Hassan AE, Millan M, Levy EI, Mitchell P, Chen M, English JD, Shah QA, Silver FL, Pereira VM, Mehta BP, Baxter BW, Abraham MG, Cardona P, Veznedaroglu E, Hellinger FR, Feng L, Kirmani JF, Lopes DK, Jankowitz BT, Frankel MR, Costalat V, Vora NA, Yoo AJ, Malik AM, Furlan AJ, Rubiera M, Aghaebrahim A, Olivot JM, Tekle WG, Shields R, Graves T, Lewis RJ, Smith WS, Liebeskind DS, Saver JL, Jovin TG, DAWN Trial Investigators. Thrombectomy 6 to 24 hours after stroke with a mismatch between deficit and infarct. N Engl J Med. 2018;378(1):11–21.

    Article  Google Scholar 

  9. Ansari SA, Darwish M, Abdalla RN, et al. GUide sheath Advancement and aspiRation in the Distal petrocavenous internal carotid artery (GUARD) technique during thrombectomy improves reperfusion and clinical outcomes. Am J Neuroradiol. 2019;40:1356–62.

    Article  CAS  Google Scholar 

  10. Ansari SA, Thompson BG, Gemmete JJ, Gandhi D. Endovascular treatment of distal cervical and intracranial dissections with the neuroform stent. Neurosurgery. 2008;62(3):636–46.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sameer A. Ansari .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Sukumaran, M., Abdalla, R.N., Cantrell, D.R., Potts, M.B., Ansari, S.A. (2021). Acute Stroke Thrombectomy and Emergent Management of Tandem Cervical Dissections. In: Hui, F.K., Spiotta, A.M., Alexander, M.J., Hanel, R.A., Baxter, B.W. (eds) 12 Strokes. Springer, Cham. https://doi.org/10.1007/978-3-030-56857-3_17

Download citation

Publish with us

Policies and ethics