Blood Vessel Dissection

A tear or separation of the layers by a blood vessel typically involving vessels under pressure, i.e., ARTERIES, e.g., AORTA. Tearing of the TUNICA INTIMA layer of a blood vessel may lead to interstitial HEMORRHAGE. Dissection between the tunica intima and TUNICA MEDIA causes luminal occlusion. Dissection at the media, or between the media and the outer ADVENTITIA causes aneurismal dilation.

Also Known As:

Dissection, Blood Vessel; Arterial Dissections; Arteries, Dissection; Artery, Dissection; Dissection Arteries; Dissection, Arterial; Arterial Dissection; Dissection Artery

Networked: 480 relevant articles (17 outcomes, 41 trials/studies)

Relationship Network

Disease Context: Research Results

Cardiovascular Diseases: 91362
- Vascular Diseases: 15138
  - Aneurysm: 24506
    - Blood Vessel Dissection: 480

Related Diseases

1.	Stroke (Strokes)
2.	Ischemia
3.	Pathologic Constriction (Stenosis)
4.	Subarachnoid Hemorrhage (Aneurysmal Subarachnoid Hemorrhage)
5.	Cerebral Infarction

Experts

1.	Pezzini, Alessandro: 9 articles (01/2022 - 01/2002)
2.	Padovani, Alessandro: 6 articles (01/2022 - 01/2002)
3.	Magoni, Mauro: 5 articles (01/2022 - 01/2002)
4.	Arnold, Marcel: 5 articles (01/2021 - 06/2011)
5.	Engelter, Stefan T: 5 articles (01/2021 - 09/2007)
6.	Traenka, Christopher: 5 articles (01/2021 - 06/2017)
7.	Nolte, Christian H: 4 articles (05/2021 - 08/2014)
8.	Michel, Patrik: 4 articles (01/2021 - 03/2018)
9.	Grond-Ginsbach, C: 4 articles (06/2015 - 11/2001)
10.	Sacco, Ralph L: 4 articles (10/2014 - 02/2006)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Blood Vessel Dissection:

1.	AnticoagulantsIBA 01/01/2013 - "In view of these results and the safety advantages, easier usage and lower cost of antiplatelets, we conclude that antiplatelets should be given precedence over anticoagulants as a first line treatment in patients with cervical artery dissection unless results of an adequately powered randomised trial suggest the opposite." 01/01/2013 - "Studies were eligible if they were randomised, quasi-randomised or observational comparisons of antiplatelets and anticoagulants in patients with cervical artery dissection. " 06/13/2022 - "There is no conclusive evidence whether antiplatelets or anticoagulants are better suited in the treatment of extracranial artery dissection. " 07/01/2019 - "Prospective data of 200 consecutive patients with a confirmed diagnosis of extracranial carotid (n = 132) or vertebral (n = 68) artery dissection (76% males; mean age, 43.5 ± 13 years) treated with antiplatelets (n = 136) or anticoagulants (n = 64) were analyzed retrospectively. " 08/01/2015 - "Helsinki experience on nonvitamin K oral anticoagulants for treating cervical artery dissection."
2.	Protons (Proton)IBA 01/01/2016 - "The purpose of this study was to assess the clinical usefulness of three-dimensional high-resolution MRI (3D-HR-MRI) including pre- and post-contrast T1-weighted volumetric isotropic turbo spin echo acquisition with improved motion-sensitized driven equilibrium preparation (3D-iMSDE-T1) and proton-density weighted image (3D-PD) in detecting dissection and to evaluate the added value of 3D-PD in diagnosing intracranial arterial dissection. " 01/01/2016 - "Added Value of 3D Proton-Density Weighted Images in Diagnosis of Intracranial Arterial Dissection."
3.	Hemostatics (Antihemorrhagics)IBA 01/01/2022 - "There was a statistically significant improvement in overall procedural success using the single closure device (94.6% vs. 88.5%, p = 0.009) This was defined as intraprocedural hemostatic control, lack of contrast extravasation, arterial dissection, occlusion, or stenosis >50% in the final crossover angiogram, as well as unimpaired limb perfusion without claudication throughout the index hospitalization. " 01/01/2022 - "Arterial dissection, intrinsic diseases of the arterial wall and stroke associated with migraine and drugs were more likely to occur at a young age, while disorders of platelets and the hemostatic system, cancer-related coagulopathy, infectious diseases, and hypoperfusion syndromes were more frequent at an old age. "
4.	Vitamin K FDA Link 06/01/2023 - "Randomized controlled trials (RCT) on the best medical therapy in the treatment of cervical artery dissection (CeAD) have demonstrated low rates of ischemia with both antiplatelet and vitamin K antagonism. " 09/22/2015 - "Given that NOACs are equivalent to vitamin K antagonists in preventing ischemic stroke and systemic embolism in patients with atrial fibrillation with less bleeding risk, clinical trials are needed to investigate the short- and long-term use of NOACs in populations of patients with other forms of cerebrovascular disease, including those with cryptogenic stroke with or without evidence of patent foramen ovale and low ejection fraction, cervical artery dissection, large artery atherosclerosis, venous thrombosis, and stuttering lacunar stroke. " 01/01/2021 - "Historically, clinicians have preferred using oral anticoagulation with vitamin K antagonists for patients with cervical artery dissection, although some current guidelines-based on available evidence from mostly observational studies-suggest using aspirin. " 03/01/2023 - "ERRATUM to Vitamin K antagonist versus novel oral anticoagulants for management of cervical artery dissection: Interactive systematic review and meta-analysis." 12/01/2022 - "Vitamin K antagonist versus novel oral anticoagulants for management of cervical artery dissection: Interactive systematic review and meta-analysis."
5.	Platelet Aggregation Inhibitors (Antiplatelet Drugs)IBA 10/10/2002 - "Patients with craniocervical arterial dissection should be investigated with ultrasound techniques and MRI or CT; antiplatelet agents or anticoagulation therapy should be considered." 10/01/1988 - "One patient died, surgical ligature of the internal carotid artery was performed in two cases, while the other patients received medical treatment with platelet inhibitors, except for the young patient affected by post-traumatic artery dissection. " 07/04/2023 - "In patients who presented with ischemic stroke, artery dissection and emergent ICA stenting who received oral antiplatelet agents post-procedure were more likely to have thrombotic events compared to those who received oral antiplatelet agents prior to or during the procedure (29% vs 9%; p = 0.04). " 07/04/2023 - "For patients who presented with ischemic stroke, artery dissection and emergent internal carotid artery (ICA) stenting who received an antiplatelet agent prior to or during the procedure, 57% were given an IV antiplatelet agent; for patients who were given an antiplatelet agent after the procedure, 96% were given an oral agent. " 01/01/2014 - "American and European guidelines support antiplatelet agents and anticoagulants as reasonable treatments of cervical artery dissection (CAD), though randomized clinical trials are lacking. "
6.	Aspirin (Acetylsalicylic Acid)FDA LinkGeneric 12/01/2021 - "Aspirin vs. anticoagulation in cervical artery dissection (TREAT-CAD): an open-label, randomised, non-inferiority trial. " 01/01/2021 - "Aspirin versus anticoagulation in cervical artery dissection (TREAT-CAD): an open-label, randomised, non-inferiority trial." 01/01/2021 - "Historically, clinicians have preferred using oral anticoagulation with vitamin K antagonists for patients with cervical artery dissection, although some current guidelines-based on available evidence from mostly observational studies-suggest using aspirin. " 01/01/2021 - "Our findings did not show that aspirin was non-inferior to vitamin K antagonists in the treatment of cervical artery dissection. " 01/01/2021 - "We aimed to test the non-inferiority of aspirin to vitamin K antagonists in patients with cervical artery dissection. "
7.	Fibrinolytic Agents (Antithrombotic Agents)IBA 01/01/2022 - "In the past, the conventional drug thrombolytic therapy had slow and limited efficacy, and the best time for treatment is easily delayed, while arterial dissection and thrombectomy treatment, although fast, is traumatic and has many complications, which is not easily accepted by patients. " 04/01/2006 - "No randomized and controlled study has evaluated acute stroke therapy and antithrombotic agents for stroke prevention in patients with spontaneous cervical artery dissection (CAD). " 01/01/2022 - "In a cohort of consecutive patients with first-ever CeAD, enrolled in the setting of the multicentre Italian Project on Stroke in Young Adults Cervical Artery Dissection, we compared postacute (beyond 6 months since the index CeAD) outcomes between patients who discontinued antithrombotic therapy and patients who continued taking antithrombotic agents during follow-up. " 07/01/2006 - "There is dire need for well planned randomized double blind controlled studies to define the role of Antithrombotic agents in "cryptogenic stroke" (PFO/ASD related) antiphospholipid antibody syndrome, arterial dissections and intraluminal clot syndromes. "
8.	Biomarkers (Surrogate Marker)IBA 09/01/2020 - "Biomarkers and antithrombotic treatment in cervical artery dissection - Design of the TREAT-CAD randomised trial." 10/23/2021 - "In 2021, The Biomarkers and Antithrombotic Treatment in of Cervical Artery Dissection (TREAT-CAD) trial however did not confirm the non-inferiority of AP therapy in stroke prevention due to CAD. " 09/01/2020 - "The 'Biomarkers and Antithrombotic Treatment in Cervical Artery Dissection' ('TREAT-CAD') trial (clinicaltrials.gov: NCT02046460) compares Aspirin to oral anticoagulants (vitamin K antagonists) with regard to efficacy and safety by using both clinical and imaging surrogate outcome measures. "
9.	CollagenIBA 01/01/2022 - "Complementary mice models haploinsufficient for Col3a1 or Col5a1, the 2 most common collagen gene variants identified in SCAD cases, demonstrated increased risk of arterial dissection and increased size of arterial diameters especially in female mice, with resulting changes in collagen fibril organization and diameter. " 02/01/2009 - "In addition, an acute arterial dissection with the circumference of whole the muscular layer was found and showed thickened collagen fibrils in the adventitia. " 09/01/2008 - "Morphometric analysis of collagen fibrils in skin of patients with spontaneous cervical artery dissection." 11/09/2004 - "Cervical artery dissection: An atypical presentation with Ehlers-Danlos-like collagen pathology?" 03/01/2004 - "Neither collagen 8A1 nor 8A2 mutations play a major role in cervical artery dissection. "
10.	Vascular Endothelial Growth Factor A (Vascular Endothelial Growth Factor)IBA 09/01/2015 - "Potential role of anti-VEGF targeted therapies in cervical artery dissection: A case report." 12/07/2021 - "Although vascular endothelial growth factor inhibitor (VPI) is well understood as a well-defined safety profile, few real-world studies are comparing the incidence, clinical features, and prognosis of the aneurysm and artery dissection. " 12/07/2021 - "Aneurysm and Artery Dissection Following the Use of Vascular Endothelial Growth Factor Inhibitor: A Real-World Analysis Using a Spontaneous Reporting System." 01/13/2021 - "VEGF inhibitors: risk of aneurysm and artery dissection. " 01/01/2017 - "Given the lack of risk factors for the disorder in the patient's history, the known cardiovascular events associated with the drug, previously described cases of arterial dissections linked to VEGF inhibitors, and the temporal relationship between the onset of symptoms and the treatment start date, a causal relationship between the CAD and lenvatinib is suggested."

Therapies and Procedures

1.	Stents 06/01/2000 - "Early model stent-grafts provided a safe and effective endovascular treatment for iliac perforations and large arterial dissections, showing a high mid-term patency rate. " 06/01/2002 - "We also suggest that endovascular stent graft placement is a useful treatment for isolated arterial dissections prior to operation in consideration of the technical ease and safety of guiding intravascular ultrasound like in this case." 03/01/2013 - "One cases of below-knee artery stent occlusion in 3 arterial dissection patients was cured by medical treatment. " 09/01/2005 - "To evaluate the safety and efficacy of stent placement for extracranial and intracranial arterial dissections. " 03/01/2005 - "We evaluated the safety and efficacy of stent angioplasty for intracranial arterial dissections. "
2.	Conservative Treatment 03/01/2014 - "Medline, Embase, and Cochrane Library databases were searched for studies comparing endovascular treatment versus conservative treatment for cervicocranial artery dissection patients. " 06/16/2020 - "Though treatment options are controversial, conservative treatment with anticoagulation should be considered in uncomplicated cases of visceral arterial dissections." 01/01/2019 - "Isolated superior mesenteric arterial dissection (ISMAD) is an uncommon type of arterial dissection and treated with surgery, stenting, or conservative management. " 11/01/2016 - "This case demonstrates that conservative management may be warranted in non-complicated isolated visceral arterial dissection." 07/12/2016 - "Conservative management of retrograde arterial dissection in the arm may be a viable option especially in asymptomatic patients due to the nature of the injury. "
3.	Lasers (Laser) 02/01/2022 - "Intravascular Ultrasound Assessment and Correlation With Angiographic Findings of Arterial Dissections Following Auryon Laser Atherectomy and Adjunctive Balloon Angioplasty: Results of the iDissection Auryon Laser Study." 01/01/1991 - "Histologically there was minimal evidence of thermal or acoustic tissue injury; however, in 4 of 16 arteries there was evidence of deep arterial dissection following laser recanalization. " 01/01/1989 - "One mechanical perforation and 2 mechanical arterial dissections by the fiber, and 1 perforation and 1 dissection by the guide wire occurred, but no complications due to the treatment or diagnostic laser were observed. " 01/01/1986 - "During laser balloon angioplasty, the tissue coagulation effects of laser-thermal energy may be used during balloon inflation to eliminate arterial dissections and to reduce elastic recoil, thereby potentially eliminating abrupt reclosure and, perhaps, reducing the incidence of restenosis associated with conventional balloon angioplasty. " 03/01/1990 - "Achieved with decremental ramped laser dosimetry, Nd:YAG laser energy has been shown to be effective in welding experimental arterial dissections over a therapeutic temperature range of 95 degrees-120 degrees C. "
4.	Catheters 04/01/2019 - "The median time of the interventional procedure was 145 min. We encountered lower percentage of distal embolization (2.4%) and artery dissection (2.4%) during usage of Rotarex catheter in our cohort. " 01/01/2019 - "Magnetic resonance imaging appears to be the preferred neurovascular imaging modality in children with arterial dissection and may obviate the need for invasive cerebral catheter angiography." 07/01/2005 - "Thirty symptomatic patients with 32 lesions, including chronic atherosclerotic (n = 21) and catheter-induced (n = 11) segmental arterial dissections, were treated with primary stenting. " 01/01/2005 - "Catheter angiography has long been considered the standard of reference for the diagnosis of cervical artery dissection. " 01/01/2005 - "Catheter angiography has been considered the standard of reference for the diagnosis of spontaneous cervical artery dissection (CAD), but carries a risk of complications and does not demonstrate the arterial wall. "
5.	Sutures (Suture) 05/01/1992 - "This bypass eliminated the need to harvest a vein graft and re-established flow using in situ intracranial vessels of similar diameter, minimal arterial dissection, and only one suture line." 02/01/2001 - "[Arterial dissection and suture repair]." 07/01/1993 - "Pull-out strength was found to be primarily a factor of the plane of preliminary arterial dissection, reflected as the amount of adventitia included in each bite; the depth of the suture was a lesser contributory factor. "