After undergoing a successful stent placement, a British boxer was protected from the risk of stroke caused by a carotid artery dissection, which occurred during his Kun Khmer training.
The doctors had to use two overlapping stents to reinforce the 80 mm-long injury.
Vascular Injury Sustained on the Training Floor
During a Kun Khmer training session in Cambodia, Mr. A.M., a 34-year-old British national, suddenly experienced extreme fatigue, dizziness, blurred vision, and uneven eye alignment. At a local hospital, Cambodian doctors diagnosed him with Horner’s syndrome caused by a vascular dissection.
An MRI scan revealed an 80mm-long dissection extending from the internal carotid artery to the skull base. Lacking experience in treating this complex condition, Cambodian doctors recommended transferring the patient to FV Hospital after four days, where advanced equipment and an experienced medical team could deliver the necessary treatment.
Dr Nguyen Minh Duc explains the patient’s condition.
After examining Mr. A.M., Dr Nguyen Minh Duc from the Neurosurgery and Endovascular Neurosurgery Department diagnosed him with carotid artery dissection. This condition occurs when the layers of the carotid artery wall separate, similar to a tear in a water pipe. Blood leaks into the middle layer of the vessel wall, forming blood clots. If untreated, it can block the blood vessel, depriving the brain of oxygen and potentially causing a stroke or sending clots to other parts of the body.
“The patient was admitted with headaches and dizziness but without weakness or paralysis. We prescribed anticoagulants to prevent blood clots and planned to intervene with other measures if the condition worsened. However, the patient was very concerned about his health and requested a stent placement procedure to definitively address the risk of recurrence,” Dr Nguyen Minh Duc recalled.
Using Two Stents to Repair a Torn Carotid Artery
Before performing the procedure, Mr. A.M was fully informed by the doctor about his condition and the treatment method. Given the 80mm-long artery dissection, two overlapping stents were required to ensure the artery remained open and clear.
The modern equipment in the Cathlab enables doctors to perform procedures with precision.
The procedure, led by Dr Duc and his team, was successfully completed within three hours in the Cathlab room, utilizing advanced equipment, including the multi-functional digital subtraction angiography (DSA) system. The system provides detailed imaging of coronary arteries, brain vessels, and the entire vascular system. Through a small incision in the thigh, the team inserted a catheter with a stent, carefully guiding it to the site of the tear in the artery. The stent was then deployed to “seal” the damaged area, restoring normal blood flow in the carotid artery.
The patient’s vascular image after the stent placement
The patient was transferred to the Cardiology and Interventional Cardiology Department for continued monitoring. The doctor prescribed long-term antiplatelet medication to prevent blood clots from forming at the stent site.
Thanks to the attentive care of the medical team, the patient recovered quickly after surgery and was discharged eight days later. Although fully recovered, the doctor advised A.M. that he could not return to competing in boxing due to the risk of re-injuring the stent.
“I’ve been competing for over 20 years; this is now the time to rest and transition to coaching. Thank you to the doctors for saving my life,” A.M. expressed gratefully.
Ho Minh Tuan, MD, PhD, checks the patient’s health before discharge.
The Risk of Stroke from Neck Injuries in Sports
Recently, sports-related injuries have become a concern not only for athletes but also individuals who engage in physical activities or exercise. For athletes, particularly those involved in combat sports, neck injuries can result in severe consequences, including reduced blood flow to the brain or even stroke.
Dr Duc advises individuals participating in combat sports to be cautious of neck injuries. Strong impacts can lead to artery dissection, reducing blood flow to the brain, or even sudden cardiac arrest caused by compression of the carotid sinus.
Neck sports injuries are a common cause of carotid artery dissection.
Ho Minh Tuan, MD, PhD, Head of the Cardiology and Interventional Cardiology Department, explained that the main causes of carotid artery dissection are usually related to two key factors: trauma and genetic vascular conditions.
“Repeated injuries, even minor ones, can damage the blood vessel walls, creating a foundation for the condition to develop. Additionally, individuals with pre-existing vascular conditions such as atherosclerosis or genetic connective tissue disorders like Marfan syndrome are at a higher risk for this condition,” Dr Tuan explained.
Carotid artery dissection typically affects individuals under 50 years old, accounting for 30-40% of stroke causes in this age group. This underscores carotid artery dissection as a significant contributor to strokes in young people.
For enquiries, please contact the Neurosurgery and Endovascular Neurosurgery Department at: (028) 5411 3333. FV Hospital offers a 20% subsidy for patients without health insurance and provides instalment payment options for hospital fees starting in December 2024.
