Contralateral Internal Carotid Artery Dissection Accompanying Internal Carotid Artery Fenestration

Background

Internal carotid artery fenestration (ICAF) is a rare congenital anomaly, with its coexistence with contralateral internal carotid artery dissection being exceptionally uncommon. Current imaging techniques may not adequately assess the risk associated with these lesions.

Data Highlights

No numerical data or trial data presented in the article.

Key Findings

• A 71-year-old female presented with episodic dizziness and was diagnosed with bilateral ICA dissections.
• Digital subtraction angiography confirmed a left ICA dissection and a right ICA fenestration.
• Computational fluid dynamics analysis revealed high-risk hemodynamic parameters for the left dissection.
• The left dissection was treated with stent-assisted coiling, while the right fenestration was managed conservatively.
• Follow-up imaging showed complete resolution of the left dissection and stable morphology of the right fenestration.

Clinical Implications

This case illustrates the importance of hemodynamic analysis in assessing the risk of ICA lesions. It suggests that individualized treatment strategies based on hemodynamic evaluations may improve patient outcomes in cases of ICAF and contralateral dissection.

Conclusion

The findings from this case highlight the utility of computational fluid dynamics in guiding treatment decisions for complex cerebrovascular anomalies. Further research may be needed to establish standardized management protocols.

Related Resources & Content

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2. Frontiers in Medicine, 2026 -- Middle cerebral artery fenestration presenting with cerebral ischemia: a case report and review of the literature
3. Frontiers in Surgery, 2026 -- Case Report: Hybrid retrograde transcarotid stenting for common carotid artery dissection secondary to acute type A aortic dissection
4. Frontiers, 2026 -- Internal carotid artery fenestration with contralateral internal carotid artery dissection: a case report and literature review
5. American Heart Association, 2024 -- Treatment and Outcomes of Cervical Artery Dissection in Adults
6. Acute Hemorrhage Management in the Cavernous Internal Carotid Artery via Emergency Endovascular Flow Diverter Stenting: Insights from a Single-Center Study
7. Frontiers | Internal carotid artery fenestration with contralateral internal carotid artery dissection: a case report and literature review
8. Treatment and Outcomes of Cervical Artery Dissection in Adults - Professional Heart Daily | American Heart Association
9. International survey on the management of cervical artery dissection: assessing consensus and variability in practice | Journal of Thrombosis and Thrombolysis | Springer Nature Link