علاج تسلخ الشريان الفقري مع انخفاض خطر النزيف وغياب السمات الإشعاعية عالية الخطورة

DOI: 10.1161/STR.0000000000000457

• Patients are stratified according to radiological risk factors for intracranial hemorrhage (eg, large infarct, hemorrhagic transformation, and intracranial extension of the dissection) and important radiological risk factors for ischemic stroke (eg, presence of intraluminal thrombus and high-grade stenosis or occlusion).
• Patients without radiographic high-risk features or those with an elevated risk of extracranial hemorrhage or ICH (eg, large infarct size, hemorrhagic transformation, intradural extension of extracranial dissection) may be better suited for antiplatelet therapy, with either antiplatelet monotherapy or a short course of dual antiplatelet therapy for 21 to 90 days (in line with minor stroke/TIA and CADISS) if considered safe, followed by single antiplatelet therapy.
• It is reasonable that the duration of antithrombotic therapy in patients with cervical artery dissection be 3–6 mo.