title: [Surgical management of penetrating cervical vascular trauma].
abstract: OBJECTIVE
  To discuss diagnosis and surgical management of penetrating cervical vascular trauma.
  
  
  METHODS
  A retrospective clinical analysis of 22 penetrating carotid artery injuries.
  
  
  RESULTS
  Twenty-two patients presented 32 vascular injuries, including innominate artery (n = 1), innominate vein (n = 2), subclavian artery (n = 6), subclavian vein (n = 2), common carotid artery (n = 3), internal carotid artery (n = 3), external carotid artery (n = 4), jugular vein (n = 8) and vertebral artery (n = 4). There were 12 patients with stab wounds, 2 with blast wound and 8 with iatrogenic injuries. Of these, there were 12 zone-1 injuries (38%), 19 zone-2 injuries (59%) and 1 zone-3 injury (3%). The distribution of 4 vertebral artery injuries were V1 (n = 1), V2 (n = 2) and V3 (n = 1). All patient received surgical and endovascular managements and got survival.
  
  
  CONCLUSIONS
  Patients with penetrating cervical vascular injuries have high rate of mortality. Emergent surgical exploration is necessary for patients with hard signs of vascular injury such as hemodynamic instability, exsanguinating hemorrhage, or expanding hematoma. Those patients that are hemodynamically stable and who are without respiratory compromise should undergo further diagnostic imaging evaluation.
authors.affiliation: Department of Vascular Surgery, Beijing Tongren Hospital, Capital Medial University, Beijing, China.
authors.forename: Zheng-li
authors.initials: ZL
authors.lastname: Tan
authors.forename: Ran
authors.initials: R
authors.lastname: Tian
authors.forename: Zheng-ya
authors.initials: ZY
authors.lastname: Yu
mesh_terms: D000293:Adolescent; D000328:Adult; D020212:Carotid Artery Injuries / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D007601:Jugular Veins / Q000293:injuries / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000098:blood supply; D019838:Neck Injuries / Q000601:surgery*; D012189:Retrospective Studies; D014950:Wounds, Penetrating / Q000601:surgery*; D055815:Young Adult