title: Management of carotid artery trauma.
abstract: With increased awareness and liberal screening of trauma patients with identified risk factors, recent case series demonstrate improved early diagnosis of carotid artery trauma before they become problematio. There remains a need for unified screening criteria for both intracranial and extracranial carotid trauma. In the absence of contraindications, antithrombotic agents should be considered in blunt carotid artery injuries, as there is a significant risk of progression of vessel injury with observation alone. Despite CTA being used as a common screening modality, it appears to lack sufficient sensitivity. DSA remains to be the gold standard in screening. Endovascular techniques are becoming more widely accepted as the primary surgical modality in the treatment of blunt extracranial carotid injuries and penetrating/blunt intracranial carotid lessions. Nonetheless, open surgical approaches are still needed for the treatment of penetrating extracranial carotid injuries and in patients with unfavorable lesions for endovascular intervention.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University Medical Center, Richmond, Virginia.
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Lee
authors.affiliation: Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas ; Department of Otolaryngology-Head & Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Yadranko
authors.initials: Y
authors.lastname: Ducic
authors.affiliation: Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas.
authors.forename: Eli
authors.initials: E
authors.lastname: Gordin
authors.affiliation: Division of Vascular Surgery, John Peter Smith Hospital, Fort Worth, Texas.
authors.forename: David
authors.initials: D
authors.lastname: Stroman
keywords: blunt carotid artery trauma; endovascular repair; extracranial carotid artery trauma; internal carotid artery; intracranial cartoid artery trauma; open repair; penetrating carotid artery trauma