Carotid artery dissection Carotid artery dissection Carotid artery dissection is a separation of the layers of the artery wall supplying oxygen-bearing blood to the head and brain and is the most common cause of stroke in young adults. (In vascular medicine, dissection is a blister-like de-lamination between the outer and inner walls of a blood vessel, generally originating with a partial leak in the inner lining.) The signs and symptoms of carotid artery dissection may be divided into ischemic and non-ischemic categories: "Non-ischemic signs and symptoms" "Ischemic signs and symptoms" The causes of internal carotid artery dissection can be broadly categorised into two
Carotid endarterectomy (CTA) or invasive angiography. Revascularization of symptomatic stenoses has a much higher therapeutic index compared to asymptomatic lesions. The North American Symptomatic Carotid Endarterectomy Trial (NASCET) and the European Carotid Surgery Trial (ECST) are both large randomized class 1 studies which have helped define current indications for carotid endarterectomy in symptomatic patients. The NASCET found that for every six patients treated, one major stroke would be prevented at two years (i.e. a number needed to treat (NNT) of six) for symptomatic patients with a 70–99% stenosis, where percent stenosis was defined as: Symptomatic patients with less severe carotid occlusion (50–69%)