When do you consider thrombectomy for patients with LVO and carotid dissection?

In most situations, unless there is no deficit, NCCT shows ICH, or CTP shows no significant penumbra.

Dissection in itself is not a contraindication to thrombectomy.

I agree with Dr. @Dr. First Last. The indication for thrombectomy would be the same as for a patient without dissection, namely LVO, with penumbra and no hemorrhage. The trick in this situation is whether to stent the carotid dissection, which would depend on the severity of the dissection.

I agree that dissection by itself is not an indication for intervention.

I agree with the prior answer. Carotid dissection can make EVT more technically challenging, but it is not an absolute contraindication. When speaking with the patient or family, I explain that there is a chance I may not be able to navigate through the dissected segment, or that a stent may be requ...