A Novel Therapeutic Strategy for Complex Cerebrovascular Disorders with Anterior Circulation Stenosis/Occlusion

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Abstract

Objective To evaluate the efficacy of treating cryptogenic vertebral artery dissections (CVADs) in patients with middle cerebral artery (MCA) stenosis/occlusion and posterior-circulation symptoms. Methods This retrospective study analyzed three patients who underwent endovascular stent reconstruction for CVADs between February 2024 and July 2025. All had symptomatic CVADs confirmed by dynamic contrast-enhanced computed tomography (DCE-CT), concurrent anterior-circulation lesions, and failed medical therapy. Results CVADs treatment alleviated posterior-circulation symptoms and improved hypoperfusion. Case 1 and 3 required staged treatments for recurring symptoms, while Case 2 improved after one treatment. Notably, parkinsonism-like symptoms in Case 3 improved post-treatment. Conclusions Targeting CVADs in complex cerebrovascular disease can improve clinical outcomes and reduce surgical risks. Further research on combined vascular-neurological therapies is warranted.

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