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Carotid artery dissection treated with stenting after anticoagulation failure
  1. Daniel Korya1,
  2. David Jeck2,
  3. John LaWall3
  1. 1University of Arizona Neurology, Arizona, USA
  2. 2Department of Neuroradiology, Tucson Medical Center, Arizona, USA
  3. 3Department of Neurology, University of Arizona, Arizona, USA
  1. Correspondence to Dr Daniel Korya, University of Arizona Neurology 1501 N Campbell Ave Tucson, Arizona 85718, USA; danielkorya{at}gmail.com

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Background

Carotid artery dissection may occur in normal healthy vessels, as well as vessels weakened by primary arteriopathy, but is most common after trauma.1 The American Heart Association/American Stroke Association guidelines (2011) concluded that it is reasonable to treat extracranial carotid artery dissection with antithrombotic medication for at least 3–6 months.2 There is little information on endovascular stenting, but most clinicians agree that this should be used on a case-by-case basis.3

Case report

A 46-year-old man, previously well, presented to the emergency department with intermittent right arm and hand weakness, left eye visual loss and word-finding difficulty. An MR scan of brain with diffusion-weighted imaging was normal. A CT angiogram of the head and neck showed a left internal carotid artery dissection. Diffusion-weighted and perfusion imaging showed no increase in transit time …

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