Interventional radiology in the treatment of internal carotid artery gunshot wounds.
OBJECTIVE
To review the indications for and techniques and results of interventional radiology in the management of internal carotid artery gunshot wounds.


METHODS
The demographics, clinical presentations, angiographic findings, methods of treatment, and outcomes were reviewed in 20 patients who underwent 21 interventional procedures.


RESULTS
Seventeen coil embolizations were successful in controlling hemorrhage. One intimal flap was compressed with balloon angioplasty, with subsequent nonoperative healing. Temporary balloon occlusions were used as a method of preoperative assessment of intracranial collateral circulation or of preoperative vascular control in three patients. There were no complications. The mortality rate was 20%.


CONCLUSIONS
Penetration of the internal carotid artery is a very severe injury with a high mortality rate due to neurologic sequelae. Interventional radiology plays an important role in the management of these wounds, and it often obviates surgical exploration.
Sclafani
S J
SJ
Department of Radiology, State University of New York Health Science Center at Brooklyn, NY 11203, USA.
Scalea
T M
TM
Hoffer
E K
EK
Herskowitz
M M
MM
Pevsner
P
P
D000293:Adolescent; D000328:Adult; D000792:Angiography; D000800:Angioplasty, Balloon; D020212:Carotid Artery Injuries; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000601:surgery; D002404:Catheterization; D003097:Collateral Circulation; D004621:Embolization, Therapeutic / Q000295:instrumentation; D005260:Female; D006470:Hemorrhage / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D015641:Radiography, Interventional; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D017539:Tunica Intima / Q000293:injuries; D014948:Wounds, Gunshot / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*