Cervicocephalic arterial dissection is an important cause of strokes in young patients. In recent years, with the improvement of the accuracy of neuroradiological imaging such as CT, MRI and cervical ultrasonography, it has become possible to diagnose it by non-invasive modalities. Cervicocephalic arterial dissection has occurred more frequently than previously reported, and has been found to be the etiology of many cerebrovascular diseases. Cervicocephalic arterial dissection causes different pathologies such as ischemic and hemorrhagic stroke, and there are many unknown points in the pathogenesis, for example assuming a complicated natural course, such as its morphological change. Medical treatment, such as anticoagulation and antiplatelet therapy, has been performed for cerebral ischemic conditions, but in recent years, endovascular treatment using a stent or a coil has been applied. However, there is still controversy about the treatment strategy, and it is expected that the appropriate treatment will be established by elucidation of its pathogenesis. We report on cervicocephalic arterial dissection of the anterior circulation based on a literature review and our cases.

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In Japan, the vertebral artery is the most frequent site of cerebral artery dissection, which often causes strokes. Recently, non-invasive imaging, such as MR angiography, has been developed for the diagnosis of cerebral artery dissection, as it can detect characteristic findings such as an intimal flap or a double lumen. However, clinical evidence indicating optimal therapeutic strategies has not yet been established because patients present various pathologies (e.g., subjective symptoms without neurologic findings, ischemic, or hemorrhagic stroke).
Conservative therapy, including antithrombotic therapy, is widely used for the treatment of non-hemorrhagic cerebral artery dissection that presents ischemic symptoms. Although it generally results in good clinical outcomes, detailed pathophysiology of progression or regression remains unknown. In contrast, a hemorrhagic cerebral artery dissection is treated with surgical intervention to prevent fatal rebleeding, as well as non-hemorrhagic cerebral artery dissection with progressive lesion and stroke.
Recently, endovascular treatment has been selected in especially posterior intracranial artery dissections due to the development of new devices such as stents and flow diverters. Herein, we review the diagnosis and endovascular treatment of the vertebral artery dissection.

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Aortic dissection (AD) is the most common event in the aorta. When it is uncomplicated, type B AD is managed medically. However, when type B AD is complicated by malperfusion, rapid aortic expansion, or rupture, intervention should be initiated.
Recently, thoracic endovascular aortic repair (TEVAR) for coverage of the proximal entry tear has been accepted as a good option in the treatment of AD. Here we describe the classification and pathological condition of AD. And indications of the TEVAR for aortic dissection are also discussed.

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Spontaneous isolated visceral artery dissection is a rare condition, but is increasingly recognized due to improvements in imaging examinations for evaluating abdominal symptoms. At present, its natural history and appropriate treatment are uncertain, but the dissection is potentially life threatening. Basically, conservative treatment is the first treatment option. However, when bowel ischemia or arterial rupture occurs, invasive treatments should be resorted to. Interventional radiological procedure such as embolization and stent placement can play an important role in the treatment of spontaneous isolated visceral artery dissection.
Herein, we introduce the management and radiological procedure for spontaneous isolated visceral artery dissection.

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Traumatic peripheral artery injury, including arterial dissection, is rare but occurs during high energy trauma, due to falls or motor vehicle accidents. Although the treatment depends on the type of injury, the primary goals are to control bleeding and avoid ischemia. Before World War II, ligation and amputation were the only options available to preserve life after such injuries. Subsequently the development of vascular surgery facilitated salvage of the injured limb and improvement of the therapeutic outcome of traumatic peripheral injury. Today, because of advances in diagnostic imaging and endovascular treatment devices, we can treat artery injuries with minimal invasiveness. Here, we focus on the pathogenesis and management of traumatic peripheral artery injury.

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