Combined Anticoagulation and Antiaggregation in Acute Cervical Artery Dissection

Cervical artery dissection (CAD) is a frequent cause of stroke in young adults. Previous studies investigating the efficiency of anticoagulation (AC) versus antiplatelet therapy (AT) found an insignificant difference. We therefore retrospectively evaluated a combination of AC plus AT in patients wit...

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Bibliographic Details
Published in:Journal of clinical medicine 2021-10, Vol.10 (19), p.4580
Main Authors: von Gottberg, Philipp, Hellstern, Victoria, Wendl, Christina, Wolf, Marc E, Niehaus, Ludwig, Bäzner, Hansjörg, Henkes, Hans
Format: Article
Language:English
Subjects:
Anticoagulants
Carotid arteries
Clinical medicine
Diabetes
Dissection
Hemorrhage
Hypertension
Magnetic resonance imaging
Medical imaging
Patients
Stroke
Veins & arteries
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Summary:Cervical artery dissection (CAD) is a frequent cause of stroke in young adults. Previous studies investigating the efficiency of anticoagulation (AC) versus antiplatelet therapy (AT) found an insignificant difference. We therefore retrospectively evaluated a combination of AC plus AT in patients with acute CAD regarding safety and efficacy. Twenty-eight patients with CAD and minor neurological symptoms/no major infarction received either single ( = 14) or dual AT ( = 14) combined with AC. Angiographic follow-up during hospitalization, 4-8 weeks and 3-6 months after CAD focused on occlusion, residual stenosis, and functional recanalization. Possible adverse events were surveyed. We compared the AC AT group to 22 patients with acute CAD treated with AC AT. Compared to preceding AC-/AT-only studies, AC single or dual AT resulted in more frequent, faster recanalization. Frequency and severity of adverse events was comparable. No major adverse events or death occurred. Preceding works on conservative treatment of CAD are discussed and compared to this study. Considerations are given to pathophysiology and the dynamic of CAD. Combining AC AT in CAD may result in more reliable recanalization in a shorter time. The risk for adverse events appears similar to treatment with only AC or AT.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm10194580