Contemporary Management and Outcomes of Carotid Artery Dissection

Abstract

Carotid artery dissection is a significant cause of stroke and the leading etiology of ischemic stroke in young and middle-aged individuals. The management of carotid artery dissection is continually evolving and varies based on the patient's clinical presentation. While carotid dissection is typically managed medically, endovascular intervention may be warranted in certain cases, and open surgical intervention is rarely employed. This qualitative review examines contemporary management strategies for cervical carotid artery dissection, highlighting 3 illustrative cases where endovascular intervention was utilized. We present one case of traumatic etiology with acute stroke symptoms, another traumatic case with progressing dissection and pseudoaneurysm evident on imaging, and a case of iatrogenic carotid dissection. Through these cases, we aim to elucidate the decision-making process and outcomes associated with endovascular treatment in the context of carotid artery dissection.