Carotid artery dissection and neurological complications after surgery for type 1 aortic dissection

. 2025 Mar 12 ; 12 (1) : . [epub] 20250312

Jazyk angličtina Země Velká Británie, Anglie Médium electronic

Typ dokumentu časopisecké články, multicentrická studie

Perzistentní odkaz   https://www.medvik.cz/link/pmid40081929

BACKGROUND: Data on the prognostic impact of type A aortic dissection involving the common carotid arteries (CCAs) are scarce. METHODS: Data on the status of the CCAs were available in 1106 patients who underwent surgery for acute DeBakey type 1 aortic dissection who were recruited in a retrospective, multicentre European registry, that is, the ERTAAD. Postoperative neurological complications were defined as ischaemic stroke, haemorrhagic stroke and/or global brain ischaemia. RESULTS: Patients without carotid artery dissection, those with unilateral or bilateral CCA dissection had in-hospital mortality rates of 19.5%, 16.9% (OR 1.006, 95% CI 0.614 to 1.647) and 27.3% (p<0.001, OR 1.719, 95% CI 1.086 to 2.722), respectively. Bilateral, but not unilateral, dissection of the CCAs increased the risk of neurological complications (40.0% vs 18.9%, OR 2.453, 95% CI 1.683 to 3.576). The negative prognostic effect of bilateral dissection of the CCAs was increased among patients without cerebral malperfusion who underwent surgery with the use of hypothermic circulatory arrest (28.7% vs 4.3%, p=0.014). CONCLUSIONS: Bilateral, but not unilateral, dissection of the CCAs may increase the risk of neurological complications and in-hospital mortality after surgery for DeBakey type 1 aortic dissection. TRIAL REGISTRATION NUMBER: NCT04831073.

Cardiac Surgery Molinette Hospital University of Turin Torino Italy

Cardiothoracic Department Azienda Sanitaria Universitaria Friuli Centrale University of Udine Udine Italy

Cardiovascular Surgery Department Hospital General Universitario Gregorio Maranon Madrid Spain

Department of Biomedical Surgical and Dental Sciences University of Milan Milan Italy

Department of Cardiac Surgery 3rd Faculty of Medicine University Hospital Kralovske Vinohrady Praha Czech Republic

Department of Cardiac Surgery Centre Hospitalier Annecy Genevois Epagny Metz Tessy France

Department of Cardiac Surgery Glenfield Hospital Leicester UK

Department of Cardiac Surgery Ludwig Maximilian University of Munich Munchen Germany

Department of Cardiac Surgery Martin Luther University Halle Wittenberg Halle Germany

Department of Cardiac Surgery Ziekenhuis Oost Limburg Genk Belgium

Department of Cardiothoracic Surgery University Hospital Munster Muenster Germany

Department of Cardiovascular Surgery Centro Cardiologico Monzino Istituto di Ricovero e Cura a Carattere Scientifico Milano Italy

Department of Cardiovascular Surgery Hospital Clínic de Barcelona University of Barcelona Barcelona Spain

Department of Cardiovascular Surgery University of Hamburg Hamburg Germany

Department of Medicine South Karelia Social and Health Care Districtm University of Helsinki Lappeenranta Finland

Department of Thoracic and Cardiovascular Surgery Centre Hospitalier Universitaire de Besancon Besancon France

Division of Cardiac Surgery Cardio thoracic and Vascular Department Azienda sanitaria universitaria Giuliano Isontina Trieste Italy

Division of Cardiac Surgery University of Verona Verona Italy

German Centre for Cardiovascular Research Partner Site Munich Heart Alliance Munich Germany

Helsinki University Hospital Heart and Lung Center Helsinki Finland

Liverpool Centre for Cardiovascular Sciences Liverpool Heart and Chest Hospital University of Liverpool Liverpool UK

National Center for Global Health Istituto Superiore di Sanità Roma Italy

Universite Paris Est Creteil Val de Marne Creteil France

Zobrazit více v PubMed

Jia S, Wang M, Liu Y, et al. Effect of Asymptomatic Common Carotid Artery Dissection on the Prognosis of Patients With Acute Type A Aortic Dissection. J Am Heart Assoc. 2024;13:e031542. doi: 10.1161/JAHA.123.031542. PubMed DOI PMC

Kreibich M, Rylski B, Czerny M, et al. Impact of Carotid Artery Involvement in Type A Aortic Dissection. Circulation. 2019;139:1977–8. doi: 10.1161/CIRCULATIONAHA.118.038099. PubMed DOI

Inoue T, Omura A, Chomei S, et al. Early and late outcomes of type A acute aortic dissection with common carotid artery involvement. JTCVS Open. 2022;10:1–11. doi: 10.1016/j.xjon.2022.01.024. PubMed DOI PMC

Luehr M, Etz CD, Nozdrzykowski M, et al. Extra-anatomic revascularization for preoperative cerebral malperfusion due to distal carotid artery occlusion in acute type A aortic dissection. Eur J Cardiothorac Surg. 2016;49:652–8. doi: 10.1093/ejcts/ezv064. PubMed DOI

Charlton-Ouw KM, Azizzadeh A, Sandhu HK, et al. Management of common carotid artery dissection due to extension from acute type A (DeBakey I) aortic dissection. J Vasc Surg. 2013;58:910–6. doi: 10.1016/j.jvs.2013.03.042. PubMed DOI

Biancari F, Onorati F, Peterss S, et al. Nature of Neurological Complications and Outcome After Surgery for Type A Aortic Dissection. Am J Cardiol. 2024;219:85–91. doi: 10.1016/j.amjcard.2024.03.001. PubMed DOI

Sultan I, Aranda-Michel E, Bianco V, et al. Outcomes of Carotid Artery Replacement With Total Arch Reconstruction for Type A Aortic Dissection. Ann Thorac Surg. 2021;112:1235–42. doi: 10.1016/j.athoracsur.2020.09.043. PubMed DOI PMC

Aggarwal P, Singh H, Mahajan S, et al. Management of thrombosis of carotid arteries in acute type A aortic dissection in neurologically intact patients: our experience. Indian J Thorac Cardiovasc Surg. 2020;36:521–5. doi: 10.1007/s12055-020-00963-8. PubMed DOI PMC

Sun J, Xue C, Zhang J, et al. Extra-anatomic revascularization and a new cannulation strategy for preoperative cerebral malperfusion due to severe stenosis or occlusion of supra-aortic branch vessels in acute type A aortic dissection. Heliyon. 2023;9:e18251. doi: 10.1016/j.heliyon.2023.e18251. PubMed DOI PMC

Roseborough GS, Murphy KP, Barker PB, et al. Correction of symptomatic cerebral malperfusion due to acute type I aortic dissection by transcarotid stenting of the innominate and carotid arteries. J Vasc Surg. 2006;44:1091–6. doi: 10.1016/j.jvs.2006.05.053. PubMed DOI

Lentini S, Tancredi F, Benedetto F, et al. Type A aortic dissection involving the carotid arteries: carotid stenting during open aortic arch surgery. Interact Cardiovasc Thorac Surg. 2009;8:157–9. doi: 10.1510/icvts.2008.186023. PubMed DOI

Ideguchi M, Kim K, Suzuki M, et al. Mechanical Thrombectomy for Acute Common Carotid Artery Occlusion. Neurol Med Chir (Tokyo) 2023;63:73–9. doi: 10.2176/jns-nmc.2022-0183. PubMed DOI PMC

Kurre W, Bansemir K, Aguilar Pérez M, et al. Endovascular treatment of acute internal carotid artery dissections: technical considerations, clinical and angiographic outcome. Neuroradiology. 2016;58:1167–79. doi: 10.1007/s00234-016-1757-z. PubMed DOI

Dmytriw AA, Phan K, Maingard J, et al. Endovascular thrombectomy for tandem acute ischemic stroke associated with cervical artery dissection: a systematic review and meta-analysis. Neuroradiology. 2020;62:861–6. doi: 10.1007/s00234-020-02388-x. PubMed DOI

Funakoshi Y, Imamura H, Tokunaga S, et al. Carotid artery stenting before surgery for carotid artery occlusion associated with acute type A aortic dissection: Two case reports. Interv Neuroradiol. 2020;26:814–20. doi: 10.1177/1591019920925690. PubMed DOI PMC

Lin C-M, Chang C-H, Chen S-W, et al. Direct Neck Exposure for Rescue Endovascular Mechanical Thrombectomy in a Patient with Acute Common Carotid Occlusion Concurrent with Type A Aortic Dissection. World Neurosurg. 2019;124:361–5. doi: 10.1016/j.wneu.2019.01.081. PubMed DOI

Yaghi S, Engelter S, Del Brutto VJ, et al. Treatment and Outcomes of Cervical Artery Dissection in Adults: A Scientific Statement From the American Heart Association. Stroke. 2024;55:e91–106. doi: 10.1161/STR.0000000000000457. PubMed DOI

Biancari F, Mariscalco G, Yusuff H, et al. European registry of type A aortic dissection (ERTAAD) - rationale, design and definition criteria. J Cardiothorac Surg. 2021;16:171. doi: 10.1186/s13019-021-01536-5. PubMed DOI PMC

von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for Reporting Observational Studies. Ann Intern Med. 2007;147:573–7. doi: 10.7326/0003-4819-147-8-200710160-00010. PubMed DOI

Salazar JD, Wityk RJ, Grega MA, et al. Stroke after cardiac surgery: short- and long-term outcomes. Ann Thorac Surg. 2001;72:1195–201. doi: 10.1016/s0003-4975(01)02929-0. PubMed DOI

Lownie SP, Larrazabal R, Kole MK. Circle of Willis Collateral During Temporary Internal Carotid Artery Occlusion I: Observations From Digital Subtraction Angiography. Can J Neurol Sci. 2016;43:533–7. doi: 10.1017/cjn.2016.9. PubMed DOI

Toyoda K, Ninomiya T. Stroke and cerebrovascular diseases in patients with chronic kidney disease. Lancet Neurol. 2014;13:823–33. doi: 10.1016/S1474-4422(14)70026-2. PubMed DOI

Moran SM, Myers BD. Course of acute renal failure studied by a model of creatinine kinetics. Kidney Int. 1985;27:928–37. doi: 10.1038/ki.1985.101. PubMed DOI

Zobrazit více v PubMed

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