• Francesco Favruzzo, Ludovica De Rosa, Alvise Fattorello Salimbeni, Stefano Mozzetta, Alessio Pieroni, Federica Viaro, Giacomo Cester, Joseph-Domenico Gabrieli, Francesco Causin, Renzo Manara, and Claudio Baracchini.
• Stroke Center, Padua University Hospital, Padua, Italy. Electronic address: francesco.favruzzo@aopd.veneto.it.
• World Neurosurg. 2023 Jun 30.

BackgroundCervical artery dissection (CeAD) causing a large vessel occlusion (LVO) stroke might represent a procedural challenge for mechanical thrombectomy (MT) impacting on its effects. The aim of the present study was to analyze safety, reperfusion rates, and clinical outcome of patients with CeAD treated by MT and compare these results with those obtained in non-CeAD patients.MethodsAll consecutive LVO stroke patients undergoing MT between June 2015 and June 2021 at our University Stroke Center were analyzed. Baseline and procedural characteristics, recanalization rates, adverse events, and functional outcome of patients with CeAD were compared with non-CeAD patients.ResultsMT was performed on 375 patients, 20 (5.3%) were diagnosed with CeAD. These patients were younger (52.9 ± 7.8 vs. 72.5 ± 12.9 years, P < 0.001), and showed lower rates of cardiovascular risk factors. In patients with CeAD, tandem occlusions were more frequent (65.0% vs. 14.4%, P < 0.001), groin to reperfusion time was longer (93.6 ± 34.9 vs. 68.3 ± 50.2 minutes, P = 0.01), and general anesthesia was more frequently utilized (70.0% vs. 27.9%, P < 0.001). Recanalization rates (Treatment in Cerebral Infarction 2b-3: 100.0% vs. 88.5%) and MT-related adverse events (10.0% vs. 10.7%) did not differ between the groups, while functional outcome was better in patients with CeAD (modified Rankin Scale 0-2 at 3 months: 85.0% vs. 62.0%, P = 0.038).ConclusionsAlthough CeAD represents a procedural challenge, MT constitutes a safe and effective treatment for patients with CeAD with LVO stroke.Copyright © 2023 Elsevier Inc. All rights reserved.

6 keywords...

hide…