title: Indirect surgical management of a penetrating vertebral artery injury.
abstract: BACKGROUND
  Vertebral artery injury caused by penetrating neck trauma is a rare occurrence. Direct surgical repair is difficult due to anatomy and exposure. Proximal and distal ligation or/and embolization represent the most common management in cases which require intervention.
  
  
  METHODS
  A young man accidentally stabbed in the neck was admitted to the emergency department with active arterial bleeding from the wound. Immediate surgical exploration revealed an isolated injury of the left vertebral artery intraosseous segment. Lesion was managed by proximal segment ligature and distal Fogarty catheter balloon-tamponade. Postoperative angiography excluded the need for further interventions. Balloon-catheter was successfully extracted after 72 hours and patient discharged neurologically intact on postoperative day 7. Fourteen months later, there are no signs of vascular or neurologic complications.
  
  
  CONCLUSIONS
  Balloon-tamponade is a valuable technical adjunct in either temporizing or definitive management of surgically inaccessible vascular trauma.
authors.affiliation: Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Siniša
authors.initials: S
authors.lastname: Pejkić
authors.affiliation: Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia Faculty of Medicine, University of Belgrade, Serbia fosafosa75@yahoo.com.
authors.forename: Nikola
authors.initials: N
authors.lastname: Ilić
authors.affiliation: Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia Faculty of Medicine, University of Belgrade, Serbia.
authors.forename: Marko
authors.initials: M
authors.lastname: Dragaš
authors.affiliation: Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Andreja
authors.initials: A
authors.lastname: Dimić
authors.affiliation: Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia Faculty of Medicine, University of Belgrade, Serbia.
authors.forename: Igor
authors.initials: I
authors.lastname: Končar
authors.affiliation: Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia Faculty of Medicine, University of Belgrade, Serbia.
authors.forename: Slobodan
authors.initials: S
authors.lastname: Cvetković
authors.affiliation: Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia Faculty of Medicine, University of Belgrade, Serbia.
authors.forename: Lazar
authors.initials: L
authors.lastname: Davidović
mesh_terms: D000328:Adult; D021721:Balloon Occlusion; D004621:Embolization, Therapeutic / Q000379:methods; D006801:Humans; D008297:Male; D018616:Ultrasonography, Doppler, Duplex; D014656:Vascular Surgical Procedures / Q000379:methods*; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D014951:Wounds, Stab / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: Vertebral artery injury; balloon-tamponade; ligature; penetrating neck trauma; therapeutic embolization