Persistent dissection of carotid artery in patients operated on for type A acute aortic dissection—carotid ultrasound follow-up

Zieliński, Tomasz; Wołkanin-Bartnik, Jolanta; Janaszek−Sitkowska, Hanna; Biederman, Andrzej; Rynkun, Dariusz; Makowiecka-Cieśla, Magdalena; Kabat, Marek

doi:10.1016/s0167-5273(99)00072-8

Cited by 30 publications

(24 citation statements)

References 14 publications

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“…9 The only documented large series reported a 15% incidence of postoperative CCA dissection with the majority of cases showing no progression and patients remaining asymptomatic during a 2-year follow-up by carotid ultrasound. 12 However, the present patient suffered a major stroke caused by right ICA occlusion 30 days after surgical repair. We were disinclined to reconstruct the right CCA because of the occlusion, and the left CCA dissection with extension to the branch was considered at high risk for malperfusion syndrome.…”

Section: Discussionmentioning

confidence: 59%

Open Retrograde Endovascular Stenting for Left Common Carotid Artery Dissection Secondary to Surgical Repair of Acute Aortic Dissection: A Case Report and Review of the Literature

Gao

Wang

Chen

2015

Annals of Vascular Surgery

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Section: Discussionmentioning

confidence: 59%

Open Retrograde Endovascular Stenting for Left Common Carotid Artery Dissection Secondary to Surgical Repair of Acute Aortic Dissection: A Case Report and Review of the Literature

Gao

Wang

Chen

2015

Annals of Vascular Surgery

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“…An aortic root operation was necessary in three additional patients (12%) and three others required a complete arch replacement (12%). The median durations of circulatory arrest, cross clamp, and cardiopulmonary bypass were 23 [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33], 93 [67. , and 182 [164-208] minutes, respectively ( Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…Patients with malperfusion had longer hospital lengths of stay {20 vs. 12 [8][9][10][11][12][13][14][15][16][17][18] days, P=0.006}, as well as more reoperations for postoperative hemorrhage (24.0% vs. 5.6%, P=0.01) and a greater number of postoperative CNS events (44.0% vs. 18.3%, P=0.01).…”

Section: Resultsmentioning

confidence: 99%

Differential outcomes of type A dissection with malperfusion according to affected organ system

Grimm¹,

Magruder²,

Crawford³

et al. 2016

Ann. Cardiothorac. Surg.

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Background: The management of malperfusion in patients with acute Stanford type A aortic dissection is controversial. We sought to determine the rate of resolution of malperfusion following primary repair of the dissection and to identify anatomic sites of malperfusion that may require additional management. Methods:We reviewed the hospital records of patients who presented to our institution with acute type A aortic dissection. Patient demographics, operative details and post-operative course were retrospectively extracted from our institutional electronic database. Depending upon the anatomic site, malperfusion was identified by a combination of radiographic and clinical definitions. Data were analyzed using standard univariable and multivariable methods. Conclusions: Malperfusion complicating acute type A dissection can be managed in many patients by aortic replacement alone with low overall mortality. Most cases of renal and cerebral malperfusion resolved following aortic surgery. Revascularization was frequently necessary in patients with extremity malperfusion.Patients presenting with intestinal ischemia had very poor outcomes. A patient-specific approach is recommended in such complex patients.

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“…3) Of patients who underwent surgical repair, such as the Bentall procedure, 15%-51% have been reported to have residual carotid artery dissection that frequently involves the right side. 3,8) Zielinski et al 9) observed dissection extension to the carotid artery in 15 (15%) of 97 survivors after surgery for aortic dissection but no late neurological abnormalities in any survivor. On the other hand, Neri et al 10) observed residual carotid artery dissection in 42 of 137 patients after surgery for aortic dissection and late neurological events occurred in 13 (30.9%), recommending strict follow-up.…”

Section: Discussionmentioning

confidence: 99%

Multiple Stenting for Extended Right Carotid Artery Dissection from Aortic Dissection via the Right Brachial Artery Approach: A Case Report

Moteki

Niimi

Inoue

et al. 2016

JNET

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Objective: We report a patient with symptomatic right carotid artery dissection due to extension from aortic dissection who underwent stenting via the right brachial artery approach.Case: A 61-year-old male underwent emergency operation for Stanford A type aortic dissection, but developed cerebral infarction due to extension of the dissection to the right carotid artery after the operation, and underwent stenting via the right brachial artery approach for the prevention of recurrence. A 6-Fr Simmons type Axcelguide was inserted, and stenting was performed with two Carotid Wallstents in conjunction with the Filterwire EZ. He showed a favorable postoperative course and was discharged home. Conclusion:When extension of dissection to the right subclavian artery is absent, stenting using the right radial artery approach should be considered as a safe procedure.

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Persistent dissection of carotid artery in patients operated on for type A acute aortic dissection—carotid ultrasound follow-up

Cited by 30 publications

References 14 publications

Open Retrograde Endovascular Stenting for Left Common Carotid Artery Dissection Secondary to Surgical Repair of Acute Aortic Dissection: A Case Report and Review of the Literature

Open Retrograde Endovascular Stenting for Left Common Carotid Artery Dissection Secondary to Surgical Repair of Acute Aortic Dissection: A Case Report and Review of the Literature

Differential outcomes of type A dissection with malperfusion according to affected organ system

Multiple Stenting for Extended Right Carotid Artery Dissection from Aortic Dissection via the Right Brachial Artery Approach: A Case Report

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