Six in ten dissected cervical arteries had fully recanalised by six months

Design

Planned subanalysis of a multicentre international retrospective cohort

Population

1,095 patients with single-vessel stenosing cervical artery dissection, 63 sites

Primary outcome

Complete recanalisation at 6 months

Effect

57.9%; occlusion at presentation OR 0.44 (0.32–0.59); diabetes OR 0.46 (0.27–0.81)

This planned subanalysis of a 63-site international cohort took 1,095 patients with imaging-confirmed single-vessel cervical artery dissection causing stenosis, all with vascular imaging at six months. Median age was 45.

Complete recanalisation occurred in 57.9%. Each extra year of age lowered the odds slightly (OR 0.97 per year), and diabetes (OR 0.46), active smoking (OR 0.69) and complete occlusion at presentation (OR 0.44) were each independently linked to incomplete healing. Occluded vessels also took longer to recanalise. Whether patients received antiplatelet therapy or anticoagulation made no difference. Recurrent stroke was numerically more common with incomplete recanalisation (5.4% vs 3.5%), but the difference was not significant.

The findings help set expectations at the six-month scan and identify who is least likely to heal. They do not yet tell us whether persisting stenosis should change antithrombotic duration or imaging intervals; that needs prospective study.

• Expect about 60% of stenosing cervical dissections to recanalise fully by six months.
• Older age, diabetes, smoking and occlusion at presentation predicted incomplete healing.
• Antiplatelet versus anticoagulant choice did not affect recanalisation.
• Support smoking cessation after dissection; smoking was linked to lower odds of healing.
• Repeat vascular imaging around six months helps plan the duration of antithrombotic therapy.

Why it matters

It gives clinicians a realistic baseline for the six-month scan and a short list of who is least likely to heal.

Don't overread it

The study cannot show that persisting stenosis raises stroke risk or that it should change treatment.

The statistics, in plain English

Odds ratios below 1 here mean lower odds of the artery healing. The recurrent stroke difference had a p value of 0.064, so it may be chance; the study was not designed to test it.

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