BACKGROUND Endovascular treatment options for internal carotid artery (ICA) dissection with tandem intracranial occlusion are evolving. We report 2 cases of stent reconstruction of carotid loop dissections. METHODS Two patients with symptomatic ICA dissections of true 360° tonsillar loops and tandem intracranial occlusions were treated with manual aspiration thrombectomy (MAT) and telescoping Zilver self-expanding peripheral stents. Patient demographics, clinical presentations, endovascular techniques, and clinical outcomes were reviewed. RESULTS In both cases, MAT achieved modified Treatment in Cerebral Ischemia scale 2B reperfusion, and complete endovascular reconstruction of the dissected extracranial loop was performed. Both patients had improved pre- to postintervention National Institutes of Health Stroke Scale scores (16 to 0 and 14 to 0), and both had modified Rankin scale scores of 1 at 3-month follow-up. CONCLUSIONS Stent reconstruction of complex cerebrovascular anatomy is increasingly feasible with advancements in stent technology and catheter support system design. This technique may be of use to neuroendovascular surgeons who encounter variant ICA anatomy.

中文翻译：

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使用伸缩外周支架重建颈动脉扁桃体环解剖的支架。

背景 用于串联颅内闭塞的颈内动脉 (ICA) 夹层的血管内治疗选择正在不断发展。我们报告了 2 例颈动脉袢夹层支架重建的病例。方法 两名有症状的 ICA 真正 360° 扁桃体环夹层和串联颅内闭塞的患者接受手动抽吸血栓切除术 (MAT) 和伸缩式 Zilver 自膨胀外周支架治疗。回顾了患者的人口统计学、临床表现、血管内技术和临床结果。结果 在这两种情况下，MAT 均实现了脑缺血评分 2B 再灌注的改良治疗，并对解剖的颅外环进行了完整的血管内重建。两名患者在干预前后都有改善的国家卫生研究院卒中量表评分（16 至 0 和 14 至 0），并且在 3 个月的随访中，他们的 Rankin 量表评分都修改为 1。结论 随着支架技术和导管支撑系统设计的进步，复杂脑血管解剖结构的支架重建越来越可行。这种技术可能对遇到不同 ICA 解剖结构的神经血管内科医生有用。