Endovascular treatment of penetrating traumatic injuries of the extracranial carotid artery.
OBJECTIVE
To describe the clinical and angiographic results of endovascular therapy for traumatic injuries of the extracranial carotid artery.


METHODS
The clinical and angiographic features of 36 traumatic injuries of the carotid artery during a 12-year period were reviewed. There were 35 male patients (97.2%) and 1 female patient (2.8%) with an average age of 28.8 years (range 13-60 years). Of the 36 lesions of the carotid artery, 29 (80.6%) were the result of gunshot injury, and 7 (19.4%) were secondary to stab wounds. In 24 (66.7%) instances, the injury resulted in a pseudoaneurysm; in 7 (19.4%), in an arteriovenous fistula (AVF); in 4 (11.1%), in a dissection; and in 1 (2.8%), in inactive bleeding. All patients were treated with an endovascular approach using different techniques (balloon occlusion, embolization, or stent deployment).


RESULTS
Endovascular therapy resulted in documented lesion occlusion in 34 (94.4%) patients. Two patients declined any follow-up postprocedural imaging; however, they have remained asymptomatic. Clinical improvement was documented in 35 (97.2%) patients, and there was one procedure-related complication with fatal consequences.


CONCLUSIONS
In this series, endovascular techniques were an effective method of treatment. It was possible to use different endovascular reconstructive techniques or parent artery occlusion depending on the degree of vessel damage, with resolution of clinical symptoms and avoidance of surgery in most cases.
Department of Radiology, Neuroradiology Section, Universidad de Antioquia, Hospital Universitario San Vicente de Paul, and CediMed, Medellin, Colombia. herrera.diego@gmail.com
Diego A
DA
Herrera
Sergio A
SA
Vargas
Arthur B
AB
Dublin
D000293:Adolescent; D000328:Adult; D000784:Aortic Dissection / Q000628:therapy; D017541:Aneurysm, False / Q000628:therapy; D001164:Arteriovenous Fistula / Q000628:therapy; D021721:Balloon Occlusion; D020212:Carotid Artery Injuries / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D004621:Embolization, Therapeutic; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D014948:Wounds, Gunshot / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D014951:Wounds, Stab / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D055815:Young Adult