Introduction: Limited data on endovascular treatment (EVT) in acute ischemic stroke (AIS) due to cervical artery dissection (CAD) is available from case series and other observational studies. We aimed to assess the potential efficacy and safety of EVT when compared to intravenous thrombolysis (IVT) alone and to no revascularization therapy.
Methods: We selected all consecutive patients with CAD-related AIS and intracranial occlusion in the Acute STroke Registry and Analysis of Lausanne (ASTRAL) from 2003 to 2017. Using a univariate analysis, we compared clinical, acute and subacute neuroimaging data of EVT group versus IVT and no revascularization treatment groups. Safety analysis included symptomatic intracerebral hemorrhage (ICH), significant radiological ICH and mortality within 7 days. Favorable clinical outcome (corrected mRS 0-2) at three-months was assessed by an adjusted binary logistic regression. 
Results: Among the 109 patients that met the inclusion criteria, 24 were treated by EVT, 38 received IVT alone, and 47 had no revascularization treatment. EVT-treated patients had a higher rate of intracranial and overall recanalization at 24 hours. Significant radiological ICH occurred more often in EVT-treated patients (EVT versus no acute treatment p=0.026), without difference in symptomatic ICH or mortality within 7 days. Favorable clinical outcome at three-months did not differ between groups (EVT versus IVT p=0.407; EVT versus no acute treatment p=0.580). 
Conclusion: In this cohort of CAD-related AIS with intracranial occlusion, EVT does not seem to be superior to IVT or no revascularization treatment. However, it seems to be safe and should not be withheld in these patients.

EFFICACY AND SAFETY OF ENDOVASCULAR TREATMENT IN ACUTE ISCHEMIC STROKE DUE TO CERVICAL ARTERY DISSECTION: A 15-YEAR CONSECUTIVE CASE SERIES