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Question:

Would a stent stabilize my carotid dissection?

I am a 52-year-old female physician. I suffered a spontaneous carotid dissection in November, now treated with Coumadin. Complicating the picture, after recent surgery for a thyroid mass now found to be medullary CA, I have had slowly progressive left sided facial dysesthesias, exactly like before the dissection was found. Would a stent stabilize this or do I have to deal with and fear these forever? I will potentially need a neck dissection in a few months. The neuro symptoms were probably 95% or more gone, prior to the thyroidectomy. The mass was 6cm and compressing my trachea, necessitating surgery even though I had some residual symptoms at the time. What would be the next step to sort this out?

Submitted by Melanie from Waco, Texas on 02/28/2015

The treatment for the carotid dissection depends upon:

1. Location, intracranial or extracranial
2. Diameter of the vessel
3. Documented ongoing ischemia
4. Presence or absence of collaterals to the region
Standard of care has been anticoagulation for 6 months.