Clinical Report: Combined Retrograde Transcarotid Stenting for CCA Dissection

Overview

This case study presents a hybrid approach using retrograde transcarotid stenting to treat left common carotid artery dissection following acute type A aortic dissection repair. The intervention resulted in complete reperfusion and favorable neurological recovery.

Background

Acute type A aortic dissection (ATAAD) can lead to complications such as common carotid artery (CCA) dissection, which may result in cerebral malperfusion and increased mortality. Traditional access routes for endovascular repair can be challenging due to altered anatomy after surgical intervention. Understanding alternative approaches, such as retrograde transcarotid access, is crucial for improving patient outcomes in these complex cases.

Data Highlights

No numerical data or trial data available in the source material.

Key Findings

• Endovascular repair is a recognized treatment for symptomatic carotid artery dissection.
• Approximately 30% of ATAAD cases are associated with CCA dissection.
• Conventional transfemoral access may be technically prohibitive post-ATAAD repair.
• Hybrid open-endovascular approaches can provide effective treatment for postoperative CCA dissection.
• The case demonstrated complete reperfusion with mTICI grade 3 and favorable neurological recovery.

Clinical Implications

Clinicians should consider hybrid approaches, such as retrograde transcarotid access, for patients with CCA dissection following ATAAD repair when traditional access routes are not feasible. This strategy may improve outcomes in cases of cerebral malperfusion.

Conclusion

The use of hybrid retrograde transcarotid stenting represents a viable salvage option for managing postoperative CCA dissection after ATAAD repair, demonstrating the potential for favorable clinical outcomes.

Related Resources & Content

1. Transcarotid Retrograde Stenting Techniques for Treating Stenosis at the Common Carotid Artery Ostium, 2025 -- Springer
2. Endovascular Retrograde Revascularization in a Case of Chronic Total Occlusion of the Internal Carotid Artery, 2021 -- Springer
3. Endovascular Recanalization through the Ascending Cervical Artery for Occlusion of Non-Conical Stump Vertebral Artery: A Case Study, 2026 -- Springer
4. Type A Aortic Dissection: From Diagnosis to Cardiac Rehabilitation, 2023 -- PMC
5. AHA SCIENTIFIC STATEMENT Treatment and Out, 2024 -- Udar
6. sentara — Carotid Endarterectomy: Surgical Treatment for Symptomatic Carotid Artery Disease
7. Type A Aortic Dissection: From Diagnosis to Cardiac Rehabilitation - PMC
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