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

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.