Endovascular management of internal carotid artery dissection with associated aneurysm using a multilayer flow modulator

Orlando López, Carlos Piñana, Laura Ludovica Gramegna, José Rodríguez, David Hernández, Alejandro Tomasello
Journal of Vascular Surgery Cases and Innovative Techniques 2020, 6 (3): 374-380
Extracranial carotid artery dissection represents up to 22% of acute neurovascular disease in young patients. There are no specific guidelines regarding indication for endovascular management of carotid artery dissection with stenting and its complications. We describe three patients with carotid artery dissection and associated dissecting aneurysm who underwent endovascular stenting with the multilayer flow modulator. At 12-month follow-up, the dissecting aneurysms were resolved, and positive clinical outcome was achieved in all patients. Our results suggest that the multilayer flow modulator may be an alternative option for endovascular interventions in patients with carotid artery dissection and pseudoaneurysms because it favors laminar flow, and it may promote spontaneous healing of the wall by progressively reducing the vascular stress in the aneurysm wall. However, further studies are needed to confirm these findings.

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