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Chen L, Hu F, Dong S, Wang J, Lin X, Zheng H, He L. Pathological migrating intramural hematoma in stenting for carotid artery dissection: A ten-year consecutive cohort study. Clin Neurol Neurosurg 2024; 236:108118. [PMID: 38237209 DOI: 10.1016/j.clineuro.2024.108118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 12/20/2023] [Accepted: 01/10/2024] [Indexed: 02/04/2024]
Abstract
OBJECTIVE To study the phenomenon, incidence and management of pathological migrating intramural hematoma in stenting for carotid artery dissection. METHODS We consecutively enrolled CAD patients with stenting treatment over 10-year period, and retrospectively analyzed the pathological migrating intramural hematoma (PMIH) incidence of these CAD patients. Besides, we also explored the related factors with PMIH and provided an appropriate management strategy. RESULTS A total of 67 CAD underwent stenting. PMIH occurred in 7 cases (10.4%). The median time from onset of symptoms to stenting was 5 days (3 to 11 days). There were 4 cases of PMIH in the proximal segment of stent and 3 cases of PMIH in the distal segment of stent. All the patients presented with new stenosis and no patient presented with dissecting aneurysm. Through proper management, none of the patients had occurred clinical complications. CONCLUSION Pathological migrating intramural hematoma phenomenon exists in the stenting for carotid artery dissection, rescue angioplasty or stenting is needed for early treatment of moderate and severe stenosis due to migrating intramural hematoma on preventing further ischemic events.
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Affiliation(s)
- Lizhang Chen
- Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu, Sichuan Province, China
| | - Fayun Hu
- Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu, Sichuan Province, China
| | - Shuju Dong
- Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu, Sichuan Province, China; The Affiliated Hospital of Kunming University of Science and Technology, 650000 Kunming, Yunnan, China; Department of Geriatrics, The First People's Hospital of Yunnan Province, 650000 Kunming, Yunnan, China
| | - Jian Wang
- Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu, Sichuan Province, China
| | - Xue Lin
- Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu, Sichuan Province, China
| | - Hongbo Zheng
- Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu, Sichuan Province, China.
| | - Li He
- Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu, Sichuan Province, China.
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