Efficacy of flow diverters for the treatment of symptomatic dissections of the cervical segment of the internal carotid artery

• We contribute to the evolving role of FDs in non-aneurysmal cerebrovascular disease. • We present one case of symptomatic internal carotid artery dissection (ICAD) treated successfully with flow diverter (FD) devices. The topic is timely and relevant, particularly given the limited literature on the application of FDs in the upper and middle C1 segments. • We provide an extensive and well-referenced discussion that reflects current clinical understanding. Internal carotid artery dissection is a relatively uncommon cerebrovascular condition that can result in neck pain, vascular stenosis, and acute stroke, particularly in young and middle-aged individuals. Vascular treatments have demonstrated potential in addressing this condition; however, the use of carotid artery stents often encounters difficulties in areas near the skull base or within tortuous vessels. Flow Diverter (FD) devices, known for their superior support and flexibility, have emerged as an innovative endovascular treatment. Despite their promise, reports on their use in cases of internal carotid artery dissection remain limited. This article discusses two cases in which FD devices were employed to treat dissections in the upper and middle segments of the C1 internal carotid artery, achieving favorable outcomes during long-term follow-up. These findings suggest that FD treatment for internal carotid artery dissection is both safe and effective, representing a feasible therapeutic option.