Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-11546
Nedeltchev, K; Bickel, S; Arnold, M; Sarikaya, H; Georgiadis, D; Sturzenegger, M; Mattle, H P; Baumgartner, R W (2009). R2-recanalization of spontaneous carotid artery dissection. Stroke, 40(2):499-504.
- Registered users only
View at publisher
BACKGROUND AND PURPOSE: We set out to investigate the predictors and time course for recanalization of spontaneous dissection of the cervical internal carotid artery (SICAD). METHODS: We prospectively included 249 consecutive patients (mean age, 45+/-11 years) with 268 SICAD. Ultrasound examinations were performed at presentation, during the first month, and then at 3, 6, and 12 months, and clinical follow-ups after 3, 6, and 12 months. RESULTS: Of 268 SICADs, 20 (7.5%) presented with </=50% stenosis, 31 (11.6%) with 51% to 80% stenosis, 92 (34.3%) with 81% to 99% stenosis, and 125 (46.6%) with an occlusion. Antithrombotic treatment included anticoagulation in 174 (67%) patients, aspirin in 64 (24%) patients, and aspirin followed by anticoagulation or vice versa in 22 (8%) patients. Follow-up ultrasound showed normal findings in 160 (60%), </=50% stenosis in 27 (10%), 51% to 80% stenosis in 4 (1%), 81% to 99% stenosis in 26 (10%), and occlusion in 51 (19%) vessels. The rate of complete recanalization was 16% at 1 month, 50% at 3 months, and 60% at 6 and 12 months. Initial occlusion of the dissected vessels reduced the odds of recanalization (OR, 4.0; 95% CI, 2.2-7.3; P<0.001), whereas the occurrence of local symptoms and signs only at presentation were independently associated with complete recanalization (OR, 0.4; 95% CI, 0.2-0.8; P=0.048). CONCLUSIONS: These results suggest that recanalization of SICAD occurs mainly within the first 6 months after the onset of symptoms. Initial occlusion reduces the likelihood of complete recanalization, whereas presentation with local symptoms and signs only increases it.
155 downloads since deposited on 22 Jun 2009
19 downloads since 12 months
|Item Type:||Journal Article, refereed, original work|
|Communities & Collections:||04 Faculty of Medicine > University Hospital Zurich > Clinic for Neurology|
|Dewey Decimal Classification:||610 Medicine & health|
|Deposited On:||22 Jun 2009 13:54|
|Last Modified:||18 Jul 2014 16:46|
|Publisher:||Lippincott Wiliams & Wilkins|
|Additional Information:||This is a non-final version of an article published in final form in Stroke: a Journal of Cerebral Circulation|
Users (please log in): suggest update or correction for this item
Repository Staff Only: item control page