{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T23:11:36Z","timestamp":1785366696846,"version":"3.55.0"},"reference-count":32,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T00:00:00Z","timestamp":1714953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Science and Higher Education of the Russian Federation","award":["075-15-2022-291"],"award-info":[{"award-number":["075-15-2022-291"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>A type A aortic dissection (TAAD) is a dangerous condition requiring emergency surgery. Due to the similarity of the symptoms of cerebral malperfusion in TAAD and the signs of ischemic stroke, a differential diagnosis of these diseases is not always available. Patients with TAAD after cerebral malperfusion can have a neurological deficit. Thrombolysis is performed in this case. It can worsen the patient\u2019s condition and increase the risk of mortality and disability. The aim of the study is to evaluate the new approach to restoring cerebral perfusion during aortic dissection. This approach includes endovascular recanalization and carotid stenting. Methods: Two clinical cases of TAAD complicated by cerebral malperfusion are described. The first patient is 73 years old and was admitted as planned to perform transcatheter aortic valve implantation (TAVI) for grade III aortic stenosis. The patient underwent transcatheter aortic valve implantation (TAVI) on the second day after admission. The second patient is 60 years old and was hospitalized by an ambulance with strong hypertension and ischemia. The surgical correction of aortic dissection was postponed until the neurological status assessment in both patients. Results: The surgery to correct the aorta dissection was deemed inappropriate. The carotid arteries have been reanalyzed, and cerebral perfusion has been restored in a short time in both patients. Conclusion: Acute bilateral internal carotid occlusion is a potentially fatal TAAD outcome. Emergency endovascular recanalization and carotid stenting may be considered one of the few ways to restore cerebral perfusion.<\/jats:p>","DOI":"10.3390\/jcm13092716","type":"journal-article","created":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T14:26:11Z","timestamp":1715005571000},"page":"2716","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Endovascular Recanalization and Carotid Stenting: The New Approach to Restore Cerebral Perfusion during Aortic Dissection"],"prefix":"10.3390","volume":"13","author":[{"given":"Maxim","family":"Agarkov","sequence":"first","affiliation":[{"name":"Interventional Radiology Gusev Central District Hospital, 56, Moskovskaya Str., Gusev, 238051 Kaliningrad Oblast, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirill","family":"Kozlov","sequence":"additional","affiliation":[{"name":"Military Medical Academy of Ministry of Defense of the Russian Federation, 6, Akademica Lebedeva Str., 194044 St. Petersburg, Russia"},{"name":"St. Petersburg Institute of Bioregulation and Gerontology, 3 Dynamo Ave., 197110 St. Petersburg, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1165-0285","authenticated-orcid":false,"given":"Ekaterina","family":"Senkina","sequence":"additional","affiliation":[{"name":"Alexander\u2019s Hospital, 4, Solidarnosti Ave., 193312 St. Petersburg, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergey","family":"Gornov","sequence":"additional","affiliation":[{"name":"The Federal Medical-Biological Agency of Russia, 30, Volocolamskoye Highway, 123182 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5156-5421","authenticated-orcid":false,"given":"Natalia","family":"Linkova","sequence":"additional","affiliation":[{"name":"St. Petersburg Institute of Bioregulation and Gerontology, 3 Dynamo Ave., 197110 St. Petersburg, Russia"},{"name":"St. Petersburg Research Institute of Phthisiopulmonology, 2-4 Ligovskii Ave., 191036 St. Petersburg, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Kechaeva","sequence":"additional","affiliation":[{"name":"St. Petersburg Research Institute of Phthisiopulmonology, 2-4 Ligovskii Ave., 191036 St. Petersburg, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7401-258X","authenticated-orcid":false,"given":"Dmitrii","family":"Medvedev","sequence":"additional","affiliation":[{"name":"St. Petersburg Institute of Bioregulation and Gerontology, 3 Dynamo Ave., 197110 St. Petersburg, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Krasichkov","sequence":"additional","affiliation":[{"name":"Department of Radio Engineering Systems of Electrotechnical University LETI, 5F Prof. Popova Str., 197022 St. Petersburg, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasiia","family":"Dyatlova","sequence":"additional","affiliation":[{"name":"St. Petersburg Institute of Bioregulation and Gerontology, 3 Dynamo Ave., 197110 St. Petersburg, Russia"},{"name":"St. Petersburg Research Institute of Phthisiopulmonology, 2-4 Ligovskii Ave., 191036 St. Petersburg, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8682-9909","authenticated-orcid":false,"given":"Victoria","family":"Polyakova","sequence":"additional","affiliation":[{"name":"St. Petersburg Institute of Bioregulation and Gerontology, 3 Dynamo Ave., 197110 St. Petersburg, Russia"},{"name":"St. Petersburg Research Institute of Phthisiopulmonology, 2-4 Ligovskii Ave., 191036 St. Petersburg, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"256","DOI":"10.21037\/acs.2016.05.04","article-title":"Type A Aortic Dissection","volume":"5","author":"Harris","year":"2016","journal-title":"Ann. Cardiothorac. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1340687","DOI":"10.3389\/fcvm.2024.1340687","article-title":"Clinical Study of Reoperation for Acute Type A Aortic Dissection","volume":"11","author":"Feng","year":"2024","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1097\/HCO.0000000000000667","article-title":"Type A Aortic Dissection Complicated by Malperfusion Syndrome","volume":"34","author":"Norton","year":"2019","journal-title":"Curr. Opin. Cardiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1016\/j.jtcvs.2022.04.051","article-title":"Outcomes of Emergency Surgery for Acute Type A Aortic Dissection Complicated by Malperfusion Syndrome","volume":"167","author":"Brown","year":"2024","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.ejcts.2007.04.012","article-title":"Significance of Malperfusion Syndromes Prior to Contemporary Surgical Repair for Acute Type A Dissection: Outcomes and Need for Additional Revascularizations","volume":"32","author":"Geirsson","year":"2007","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"65","DOI":"10.21037\/jovs.2018.03.13","article-title":"Malperfusion Syndromes in Type A Aortic Dissection: What We Have Learned from IRAD","volume":"4","author":"Berretta","year":"2018","journal-title":"J. Vis. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"I","DOI":"10.1177\/2396987321989865","article-title":"European Stroke Organisation (ESO) Guidelines on Intravenous Thrombolysis for Acute Ischaemic Stroke","volume":"6","author":"Berge","year":"2021","journal-title":"Eur. Stroke J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1177\/1538574411414301","article-title":"Endovascular Management of Symptomatic Cerebral Malperfusion Due to Carotid Dissection after Type A Aortic Dissection Repair","volume":"45","author":"Casana","year":"2011","journal-title":"Vasc. Endovasc. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1186\/s13019-017-0649-6","article-title":"Surgical Repair and Reconstruction of Aortic Arch in Debakey Type I Aortic Dissection: Recent Advances and Single-Center Experience in the Application of Branched Stent Graft","volume":"12","author":"Zhang","year":"2017","journal-title":"J. Cardiothorac. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2628","DOI":"10.1016\/j.jacc.2015.04.030","article-title":"The Impact of Pre-Operative Malperfusion on Outcome in Acute Type A Aortic Dissection: Results From the GERAADA Registry","volume":"65","author":"Czerny","year":"2015","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1177\/0218492320984329","article-title":"Type A Aortic Dissection: Involvement of Carotid Artery and Impact on Cerebral Malperfusion","volume":"29","author":"Munir","year":"2021","journal-title":"Asian Cardiovasc. Thorac. Ann."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"674","DOI":"10.2298\/VSP150402091P","article-title":"Urgent Carotid Stenting before Cardiac Surgery in a Young Male Patient with Acute Ischemic Stroke Caused by Aortic and Carotid Dissection","volume":"73","year":"2016","journal-title":"Vojn. Pregl."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1177\/1591019920925690","article-title":"Carotid Artery Stenting before Surgery for Carotid Artery Occlusion Associated with Acute Type A Aortic Dissection: Two Case Reports","volume":"26","author":"Funakoshi","year":"2020","journal-title":"Interv. Neuroradiol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Wawak, M., Tekieli, L., Badacz, R., Pieni\u0105\u017cek, P., Maciejewski, D., Trystu\u0142a, M., Przew\u0142ocki, T., and Kab\u0142ak-Ziembicka, A. (2023). Clinical Characteristics and Outcomes of Aortic Arch Emergencies: Takayasu Disease, Fibromuscular Dysplasia, and Aortic Arch Pathologies: A Retrospective Study and Review of the Literature. Biomedicines, 11.","DOI":"10.3390\/biomedicines11082207"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1517\/14740338.2015.1032242","article-title":"Safety of intravenous thrombolysis for acute ischemic stroke in specific conditions","volume":"14","author":"Tsivgoulis","year":"2015","journal-title":"Expert Opin. Drug Saf."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1093\/ejcts\/ezaa197","article-title":"Stroke in Acute Type A Aortic Dissection: The Nordic Consortium for Acute Type A Aortic Dissection (NORCAAD)","volume":"58","author":"Chemtob","year":"2020","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"ezae005","DOI":"10.1093\/ejcts\/ezae005","article-title":"Comparison of 4 Mortality Scores for Surgical Repair of Type A Aortic Dissection: A Multicentre External Validation","volume":"65","author":"Pollari","year":"2024","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"S175","DOI":"10.1161\/CIRCULATIONAHA.112.000327","article-title":"Stroke and Outcomes in Patients with Acute Type A Aortic Dissection","volume":"128","author":"Bossone","year":"2013","journal-title":"Circulation"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1093\/ejcts\/ezu538","article-title":"Is Surgery in Acute Aortic Dissection Type A Still Contraindicated in the Presence of Preoperative Neurological Symptoms?","volume":"48","author":"Most","year":"2015","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.radcr.2021.10.023","article-title":"Simultaneous Mechanical Thrombectomy for Bilateral Acute Internal Carotid Artery Occlusion","volume":"17","author":"Mai","year":"2022","journal-title":"Radiol. Case Rep."},{"key":"ref_21","first-page":"e15971","article-title":"Bilateral Internal Carotid Artery Occlusion, an Unusual Clinical Entity in a Young Adult","volume":"13","author":"Karki","year":"2021","journal-title":"Cureus"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"673","DOI":"10.2176\/nmccrj.cr.2021-0089","article-title":"Acute Thrombectomy for Contralateral Internal Carotid Artery Occlusion after Revascularization Surgery for Quasi-Moyamoya Disease: A Case Report","volume":"8","author":"Ogawa","year":"2021","journal-title":"NMC Case Rep. J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1007\/s00270-013-0746-4","article-title":"Endovascular Treatment in Two Cases of Bilateral Ischemic Stroke","volume":"37","author":"Pop","year":"2014","journal-title":"Cardiovasc. Interv. Radiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e344","DOI":"10.1161\/STR.0000000000000211","article-title":"Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association\/American Stroke Association","volume":"50","author":"Powers","year":"2019","journal-title":"Stroke"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"E143","DOI":"10.1093\/ons\/opz230","article-title":"Simultaneous Bilateral Carotid Thrombectomies: A Technical Note","volume":"18","author":"Larrew","year":"2020","journal-title":"Oper. Neurosurg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"144","DOI":"10.2478\/raon-2020-0017","article-title":"Mechanical Recanalization for Acute Bilateral Cerebral Artery Occlusion\u2014Literature Overview with a Case","volume":"54","author":"Jeromel","year":"2020","journal-title":"Radiol. Oncol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/j.clinimag.2021.02.013","article-title":"Acute Bilateral Internal Carotid Artery Occlusion: A Novel Approach to Management of a Catastrophic Clinical Entity","volume":"76","author":"Beutler","year":"2021","journal-title":"Clin. Imaging"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1007\/s12028-007-0076-y","article-title":"Bilateral Internal Carotid Artery Occlusions Resulting in near Total Acute Brain Infraction","volume":"7","author":"Zubkov","year":"2007","journal-title":"Neurocrit. Care"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1159\/000442530","article-title":"Management of Bilateral Carotid Occlusive Disease","volume":"4","author":"Jadhav","year":"2016","journal-title":"Interv. Neurol."},{"key":"ref_30","first-page":"799","article-title":"Acute Aortic Dissection Complicated by Lower Limb Ischemia: Evaluation of Ischemic Severity and Appropriate Surgical Technique","volume":"76","author":"Iida","year":"2023","journal-title":"Kyobu Geka"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Chen, S., Peng, H., Zhuang, H., Wang, J., Yan, P., Zhang, W., Zheng, W., Li, M., and Wu, X. (2024). Optimized Strategy to Improve the Outcomes of Acute Type A Aortic Dissection with Malperfusion Syndrome. J. Thorac. Cardiovasc. Surg., in press.","DOI":"10.1016\/j.jtcvs.2024.01.006"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1177\/15266028211050313","article-title":"Retrograde Carotid Stenting Using Newly Released Venous Stent for Cerebral Malperfusion in Type A Aortic Dissection","volume":"29","author":"Mukherjee","year":"2022","journal-title":"J. Endovasc. Ther."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/9\/2716\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:40:04Z","timestamp":1760107204000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/9\/2716"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,6]]},"references-count":32,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2024,5]]}},"alternative-id":["jcm13092716"],"URL":"https:\/\/doi.org\/10.3390\/jcm13092716","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,6]]}}}