Introduction
Acute type A aortic dissection (ATAAD) is a life-threatening disease
that can present with severe neurological deficits such as a hemi
symptomatic aor a comatose state caused by cerebral malperfusion (CM).
CM due to concomitant dissection of the supra-aortic vessels with
carotid artery occlusion is of especially poor prognosis, with up to
40% in-hospital mortality (1).
Established consensus in the treatment of ATAAD patients is immediate
surgery in order to replace the damaged aortic segments, obliterate
blood flow in the false lumen and restore blood supply of the brain and
visceral organs. Nonetheless, surgical repair for ATAAD in presence of
internal carotid artery (ICA) obstruction may often be futile, as
patients are of high risk of developing cerebral edema and herniation
syndrome, and has recently been shown of fatal prognosis(1).
Here, were present a case of an ATAAD patient with left-sided ICA
occlusion, in whom percutaneous carotid recanalization and stenting was
performed prior to open aortic surgery in order to restore cerebral
perfusion in an interdisciplinary, staged treatment approach.