Key result
Urgent carotid stenting via a combined antegrade-retrograde approach restored carotid patency without major complications in 1 patient with post-arch replacement dissection.
Why the study?
Type A aortic dissection extending into the carotid arteries with true lumen compression poses a significant risk of cerebral hypoperfusion and neurological sequelae, requiring salvage strategies when traditional methods fail.
Case Report (n=1)
Answers are grounded in this paper and cite their sources.
A combined antegrade-retrograde (trans carotid and trans radial) approach for urgent carotid stenting represents a viable salvage strategy for managing true lumen compression in complex Type A aortic dissections following total arch replacement.
Type A aortic dissection extending into the carotid arteries with true lumen compression poses a significant risk of cerebral hypoperfusion and neurological sequelae. This case report describes an elderly patient who developed an extension of the right common carotid artery dissection with associated true lumen compression immediately following total arch replacement for acute Type A aortic dissection. Urgent carotid stenting was performed using a combined antegrade-retrograde approach (trans carotid and trans radial approach) to restore blood flow. Postprocedural imaging confirmed patency without major complications. This technique highlights a viable salvage strategy for managing complex aortic dissections when traditional methods fail. A literature review discusses the combined antegrade-retrograde approach used in urgent carotid stenting, as well as the advantages of ultrasound in selecting the true lumen and its minimally invasive nature.
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Ng et al. (2026) conducted a case report in Right common carotid artery dissection with true lumen compression following total arch replacement for acute Type A aortic dissection (n=1). Urgent carotid stenting using a combined antegrade-retrograde (trans carotid and trans radial) approach was evaluated on Blood flow restoration and vessel patency without major complications. Urgent carotid stenting via a combined antegrade-retrograde approach restored carotid patency without major complications in 1 patient with post-arch replacement dissection.
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