Dissection | Cortex Neurovascular

Understanding Carotid and Vertebral Dissections

Carotid and vertebral artery dissections are injuries that occur in the major arteries supplying blood to the brain. They can result from trauma, genetic conditions, or spontaneously, leading to the tearing or separation of the artery's layers, creating a false lumen where blood can accumulate and form a clot, obstructing blood flow or causing a stroke.

Patients may experience sudden, severe headaches, neck pain, pulsatile tinnitus, visual disturbances, or stroke-like symptoms such as weakness, facial droop, difficulty speaking, and loss of coordination.

While dissections oftentimes heal on their own, certain associated findings can complicate or prevent healing and potentially require repair.

Dissection Flaps: A tear in the artery wall that can act as a flap, allowing blood to enter the vessel wall and potentially obstruct blood flow.

Pseudoaneurysms: Occur when blood escapes through the tear and pools between the artery's layers, forming a bulge that mimics an aneurysm.

Stenoses: Narrowing of the arteries caused by the dissection, which can reduce blood flow to the brain, leading to ischemic symptoms.

Our treatment goal is to restore normal blood flow and prevent stroke. Depending on the dissection's location, severity, and symptoms, treatment options include:
Medical Management: Initial treatment often involves antiplatelet or anticoagulant medications to prevent clot formation and stroke.
Endovascular Treatment: For cases where medical management is insufficient or the risk of stroke is high, we may recommend endovascular procedures such as stenting to stabilize the dissection flap, close off pseudoaneurysms, or widen narrowed sections of the artery.

Stenting

Stenting is a primary endovascular treatment for artery dissections. The procedure involves the insertion of a stent, a small tube-shaped device, into the affected artery to support the torn vessel wall and prevent the dissection from worsening.

Embolization

Embolization is particularly useful for treating pseudoaneurysms associated with dissections. Through this technique, embolic agents (such as coils) are delivered to the pseudoaneurysm, promoting clotting and sealing off the abnormal bulge to prevent rupture.

Flow-Diverting Stents

Specifically designed for complex dissections and aneurysms, these stents redirect blood flow away from the affected area, promoting healing of the vessel wall.

Minimally Invasive

Procedures are performed through small incisions, reducing recovery time and risk of complications.

Highly Effective

These treatments provide immediate stabilization of dissections and restoration of blood flow, with a lower risk of recurrence.

Customized Treatment

Endovascular options allow for personalized treatment plans based on the specific location, size, and nature of the dissection.

Our goal is to ensure the best possible outcomes for our patients, offering innovative solutions and support every step of the way.