Therapeutic endovascular treatments for traumatic carotid artery injuries.
OBJECTIVE
The diagnosis and management of traumatic carotid vessel injuries continue to be controversial, with direct surgical repair with parent artery preservation still presenting difficulties. The purpose of this report is to review the endovascular therapy of patients with traumatic carotid vessel injuries for preservation of the parent artery, and to determine the safety and efficacy of endovascular therapy.


METHODS
Ten patients with traumatic carotid lesions were treated using therapeutic endovascular methods. Endovascular therapy was accomplished by implanting balloons, porous or polytetrafluoroethylene-covered stents, and/or embolic materials including coils or glue.


RESULTS
All fistulas and pseudoaneurysms were successfully embolized with no periprocedural complications including vessel disruption/rupture, distal embolization, or new neurologic deficits. The parent arteries of all patients except one were preserved. The reason for the parent artery sacrifice was a thrombus formation due to coil migration into the parent artery. No additional surgical procedures for vascular lesions were required. There were no delayed neurologic or vascular complications, and no lesions recurred during the follow-up periods (mean 20.3 months).


CONCLUSIONS
The goal of endovascular therapy is the selective elimination of the vascular pathology with the normal patency of the cerebral arteries. The authors' experience demonstrates that endovascular therapy using stents, balloons, and coils is both feasible and safe for treatment of traumatic carotid injuries. Of these endovascular methods, the stent can be used to exclude the aneurysm or fistula from the circulation and preserve the parent artery in selective cases. Long-term follow-up review of these repairs will be necessary to provide a full evaluation of the safety and efficacy of these devices.
Department of Neurosurgery, Yonsei University College of Medicine, Seoul, South Korea.
Jin Yang
JY
Joo
Jung Yong
JY
Ahn
Young Sun
YS
Chung
Sang Sup
SS
Chung
Sang Heum
SH
Kim
Pyeong Ho
PH
Yoon
Ok Joon
OJ
Kim
D000328:Adult; D000784:Aortic Dissection / Q000000981:diagnostic imaging; D000800:Angioplasty, Balloon; D020212:Carotid Artery Injuries / Q000000981:diagnostic imaging / Q000628:therapy*; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D015607:Stents; D016157:Vascular Fistula / Q000628:therapy