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In Patients with Carotid Artery Dissection, Is Stenting Superior to Open Repair to Improve Clinical Outcomes?

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Difficult Decisions in Vascular Surgery

Part of the book series: Difficult Decisions in Surgery: An Evidence-Based Approach ((DDSURGERY))

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Abstract

Carotid artery dissection is a rare but potentially devastating entity. Clinical sequale can include stroke, cranial nerve dysfunction, carotid stenosis, and pseudoaneurym formation. Anticoagulation is the mainstay of treatment, but in patients who fail anticoagulation or have contraindications to anticoagulation, surgical therapy is often considered. Open surgical repair had historically been the traditional therapy of choice, but percutaneous therapy with stent placement has become increasingly commonplace. No randomized trials exist regarding optimal surgical management of carotid artery dissection. Current literature supports both open and endovascular treatment as safe and effective for carotid artery dissection.

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Authors and Affiliations

  1. Division of Vascular Surgery and Endovascular Therapy, Emory University School of Medicine, Atlanta, GA, USA

    Reshma Brahmbhatt MD

  2. Division of Vascular Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA

    Ravi R. Rajani MD

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  1. Reshma Brahmbhatt MD
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Correspondence to Ravi R. Rajani MD .

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  1. The University of Chicago Medical Center and Biological Science Division, Chicago, Illinois, USA

    Christopher L. Skelly

  2. The University of Chicago Medical Center and Biological Science Division, Chicago, Illinois, USA

    Ross Milner

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Brahmbhatt, R., Rajani, R.R. (2017). In Patients with Carotid Artery Dissection, Is Stenting Superior to Open Repair to Improve Clinical Outcomes?. In: Skelly, C., Milner, R. (eds) Difficult Decisions in Vascular Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach. Springer, Cham. https://doi.org/10.1007/978-3-319-33293-2_32

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