{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T02:59:15Z","timestamp":1772765955491,"version":"3.50.1"},"reference-count":16,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction. Cervical artery dissection (CAD) is a rare condition, being one of the leading causes of stroke in patients under the age of 45, with a reported prevalence of up to 20%. The management of CAD remains controversial due to its rarity and the lack of large-scale randomized controlled trials. The aim of this study was to report the long-term outcomes of CAD in a real-world setting. Methods. This retrospective, observational, single-center study included patients diagnosed with CAD between 2010 and 2019 (approval number: 153\/2015\/U\/Oss\/AOUBo). Clinical presentation, risk factors, and medical therapies were prospectively analyzed. Management strategies included both medical and interventional approaches. Follow-up consisted of annual clinical visits and carotid duplex ultrasound (DUS), with telephone interviews every six months. The primary endpoint was defined by the overall long-term stroke\/death rate and in relation to the type of medical treatment, localization of the dissection and clinical manifestations. Results. A total of 62 patients were included, predominantly male (65%) with a mean age of 58 (\u00b12) years. Thirteen dissections (21%) were trauma-related. CAD locations included the common carotid artery in 6 cases (10%), extracranial internal carotid artery in 29 (46%), intracranial internal carotid artery in 9 (14%), and vertebral artery in 16 (25%). One patient (2%) had dissections in both the extracranial internal carotid and vertebral arteries, and another (2%) in both the vertebral and basilar arteries. Bilateral dissections were observed in 5 patients (8%). Ischemic manifestations occurred in 43 patients (68%): 10 transient ischemic attacks (16%), 17 minor strokes (27%), and 16 major strokes (25%), with ischemic lesions on cerebral CT in 31 cases (72%). Fifty-eight (93%) patients were treated medically (anticoagulants and\/or antiplatelets), while 4 patients (7%) underwent surgical or endovascular intervention. The mean follow-up was 81 \u00b1 35 months. During this period, 2 patients (4%) experienced stroke and 15 (24%) died. The estimated 10-year survival rate was 71%, and the 10-year stroke\/death-free survival rate was 70%. Among medically treated patients, the 10-year stroke\/death-free survival was 86% for those on anticoagulation and 67% for those on antiplatelet therapy (p = 0.1). Patients presenting with ischemic symptoms had a lower estimated 10-year stroke\/death-free survival rate compared to those with non-ischemic presentations (61% vs. 69%, p = 0.7). Patients with dissection of the common carotid artery had a significantly lower estimated 10-year stroke\/death-free survival rate (25%), compared to dissections in other cervical arteries (p = 0.001). Conclusions. In this real-world, single-center experience, cervical artery dissection was associated with a favorable long-term prognosis in most cases, especially among patients managed conservatively with medical therapy. Stroke and mortality rates were relatively low during extended follow-up. Although no statistically significant difference was observed between anticoagulation and antiplatelet therapy, the trend favored anticoagulation for stroke\/death-free survival. Patients with CCA dissections had significantly worse 10-year stroke\/death-free survival compared to those with dissections in other cervical arteries.<\/jats:p>","DOI":"10.3390\/jcm14196836","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T14:50:38Z","timestamp":1758898238000},"page":"6836","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Ten-Year Outcomes of Cervical Artery Dissection: A Retrospective Study in a Real-World Cohort"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-2369-9124","authenticated-orcid":false,"given":"Marcello","family":"Lodato","sequence":"first","affiliation":[{"name":"Vascular Surgery Unit, IRCCS University Hospital Policlinico S. Orsola, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodolfo","family":"Pini","sequence":"additional","affiliation":[{"name":"Vascular Surgery, University of Bologna, DIMEC, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandra","family":"Porcelli","sequence":"additional","affiliation":[{"name":"Vascular Surgery Unit, IRCCS University Hospital Policlinico S. Orsola, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrico","family":"Gallitto","sequence":"additional","affiliation":[{"name":"Vascular Surgery Unit, IRCCS University Hospital Policlinico S. Orsola, 40138 Bologna, Italy"},{"name":"Vascular Surgery, University of Bologna, DIMEC, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Vacirca","sequence":"additional","affiliation":[{"name":"Vascular Surgery Unit, IRCCS University Hospital Policlinico S. Orsola, 40138 Bologna, Italy"},{"name":"Vascular Surgery, University of Bologna, DIMEC, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauro","family":"Gargiulo","sequence":"additional","affiliation":[{"name":"Vascular Surgery Unit, IRCCS University Hospital Policlinico S. Orsola, 40138 Bologna, Italy"},{"name":"Vascular Surgery, University of Bologna, DIMEC, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluca","family":"Faggioli","sequence":"additional","affiliation":[{"name":"Vascular Surgery Unit, IRCCS University Hospital Policlinico S. Orsola, 40138 Bologna, Italy"},{"name":"Vascular Surgery, University of Bologna, DIMEC, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1016\/j.ncl.2014.12.002","article-title":"Diagnosis and treatment of cervical artery dissection","volume":"33","author":"Engelter","year":"2015","journal-title":"Neurol. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Wawak, M., Tekieli, \u0141., 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. 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