Combined intravenous recombinant-tissular plasminogen activator and endovascular treatment of spontaneous occlusive internal carotid dissection with tandem intracranial artery occlusion

Eur Neurol. 2010;63(4):211-4. doi: 10.1159/000278248. Epub 2010 Mar 9.


Internal carotid artery (ICA) dissection with tandem internal carotid and middle cerebral artery occlusion may carry a poor prognosis even if intravenous recombinant-tissular plasminogen activator is administered. A better outcome may be expected with the combination of intravenous thrombolysis and endovascular methods (stenting and thromboaspiration). This procedure was performed in 3 patients who had concurrent ICA dissection and intracerebral occlusion. Endovascular treatment was feasible and safe. All our patients had a good clinical outcome. This potential effective approach may need further validation.

MeSH terms

  • Adult
  • Carotid Artery, Internal, Dissection / complications
  • Carotid Artery, Internal, Dissection / therapy*
  • Cerebral Angiography
  • Cerebral Revascularization / methods*
  • Diffusion Magnetic Resonance Imaging / methods
  • Drug Administration Routes
  • Fibrinolytic Agents / therapeutic use*
  • Humans
  • Infarction, Middle Cerebral Artery / complications
  • Infarction, Middle Cerebral Artery / therapy*
  • Injections, Intravenous / methods
  • Male
  • Stents
  • Tissue Plasminogen Activator / therapeutic use*
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Young Adult


  • Fibrinolytic Agents
  • Tissue Plasminogen Activator