Treatment of blunt injury to the carotid artery by using endovascular stents: an early experience

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  • 1 Departments of Surgery (Neurosurgery) and Radiology, University of Colorado Health Sciences Center and Denver Health Medical Center, Denver, Colorado
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✓ Identification of blunt carotid injury prior to the development of ischemic symptoms requires aggressive screening of patients at risk. The treatment of these lesions has centered around long-term anticoagulation therapy. However, studies have revealed that many of these lesions persist despite medical treatment, as does the risk of distal embolization. The authors present a series of six patients who were successfully treated by means of endovascular stent placement for nonpenetrating carotid injuries. In the authors' experience this treatment requires only temporary anticoagulation therapy, results in immediate reconstruction of the injured vessel, obliterates pseudoaneurysms, and prevents distal embolization.

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Contributor Notes

Address reprint requests to: Kerry E. Brega, M.D., Department of Surgery, University of Colorado Health Sciences Center, 777 Bannock Street, Denver, Colorado 80204–4507.
  • 1.

    Batzdorf U, , Bentson JR, & Machleder HI: Blunt trauma to the high cervical carotid artery. Neurosurgery 5:195201, 1979 Batzdorf U, Bentson JR, Machleder HI: Blunt trauma to the high cervical carotid artery. Neurosurgery 5:195–201, 1979

    • Search Google Scholar
    • Export Citation
  • 2.

    Cogbill TH, , Moore EE, & Meissner M, et al: The spectrum of blunt injury to the carotid artery: a multicenter perspective. J Trauma 37:473479, 1994 Cogbill TH, Moore EE, Meissner M, et al: The spectrum of blunt injury to the carotid artery: a multicenter perspective. J Trauma 37:473–479, 1994

    • Search Google Scholar
    • Export Citation
  • 3.

    Crissey MM, & Bernstein EF: Delayed presentation of carotid intimal tear following blunt craniocervical trauma. Surgery 75:543549, 1974 Crissey MM, Bernstein EF: Delayed presentation of carotid intimal tear following blunt craniocervical trauma. Surgery 75:543–549, 1974

    • Search Google Scholar
    • Export Citation
  • 4.

    Davis JW, , Holbrook TL, & Hoyt DB, et al: Blunt carotid artery dissection: incidence, associated injuries, screening, and treatment. J Trauma 30:15141517, 1990 Davis JW, Holbrook TL, Hoyt DB, et al: Blunt carotid artery dissection: incidence, associated injuries, screening, and treatment. J Trauma 30:1514–1517, 1990

    • Search Google Scholar
    • Export Citation
  • 5.

    Dragon R, , Saranchak H, & Lakin P, et al: Blunt injuries to the carotid and vertebral arteries. Am J Surg 141:497500, 1981 Dragon R, Saranchak H, Lakin P, et al: Blunt injuries to the carotid and vertebral arteries. Am J Surg 141:497–500, 1981

    • Search Google Scholar
    • Export Citation
  • 6.

    Fabian TC, , Patton JH Jr, & Croce MA, et al: Blunt carotid injury. Importance of early diagnosis and anticoagulant therapy. Ann Surg 223:513525, 1996 Fabian TC, Patton JH Jr, Croce MA, et al: Blunt carotid injury. Importance of early diagnosis and anticoagulant therapy. Ann Surg 223:513–525, 1996

    • Search Google Scholar
    • Export Citation
  • 7.

    Krajewski LP, & Hertzer NR: Blunt carotid artery trauma: report of two cases and review of the literature. Ann Surg 191:341346, 1980 Krajewski LP, Hertzer NR: Blunt carotid artery trauma: report of two cases and review of the literature. Ann Surg 191:341–346, 1980

    • Search Google Scholar
    • Export Citation
  • 8.

    Marks MP, , Dake MD, & Steinberg GK, et al: Stent placement for arterial and venous cerebrovascular disease: preliminary experience. Radiology 191:441446, 1994 Marks MP, Dake MD, Steinberg GK, et al: Stent placement for arterial and venous cerebrovascular disease: preliminary experience. Radiology 191:441–446, 1994

    • Search Google Scholar
    • Export Citation
  • 9.

    Martin RF, , Eldrup-Jorgensen J, & Clark DE, et al: Blunt trauma to the carotid arteries. J Vasc Surg 14:789793, 1991 Martin RF, Eldrup-Jorgensen J, Clark DE, et al: Blunt trauma to the carotid arteries. J Vasc Surg 14:789–793, 1991

    • Search Google Scholar
    • Export Citation
  • 10.

    Mase M, , Banno T, & Yamada K, et al: Endovascular stent placement for multiple aneurysms of the extracranial internal carotid artery: technical case report. Neurosurgery 37:832835, 1995 Mase M, Banno T, Yamada K, et al: Endovascular stent placement for multiple aneurysms of the extracranial internal carotid artery: technical case report. Neurosurgery 37:832–835, 1995

    • Search Google Scholar
    • Export Citation
  • 11.

    Mokri B, , Piepgras DG, & Houser OW: Traumatic dissections of the extracranial internal carotid artery. J Neurosurg 68:189197, 1988 Mokri B, Piepgras DG, Houser OW: Traumatic dissections of the extracranial internal carotid artery. J Neurosurg 68:189–197, 1988

    • Search Google Scholar
    • Export Citation
  • 12.

    New PF, & Mamose KJ: Traumatic dissection of the internal carotid artery at the atlantoaxial level, secondary to nonpenetrating injury. Radiology 93:4149, 1969 New PF, Mamose KJ: Traumatic dissection of the internal carotid artery at the atlantoaxial level, secondary to nonpenetrating injury. Radiology 93:41–49, 1969

    • Search Google Scholar
    • Export Citation
  • 13.

    Palmaz JC, , Richter GM, & Noeldge G, et al: Intraluminal stents in atherosclerotic iliac artery stenosis: preliminary report of a multicenter study. Radiology 168:727731, 1988 Palmaz JC, Richter GM, Noeldge G, et al: Intraluminal stents in atherosclerotic iliac artery stenosis: preliminary report of a multicenter study. Radiology 168:727–731, 1988

    • Search Google Scholar
    • Export Citation
  • 14.

    Parodi JC: Endovascular repair of abdominal aortic aneurysms and other arterial lesions. J Vasc Surg 21:549557, 1995 Parodi JC: Endovascular repair of abdominal aortic aneurysms and other arterial lesions. J Vasc Surg 21:549–557, 1995

    • Search Google Scholar
    • Export Citation
  • 15.

    Perry MO, , Snyder WH, & Thal ER: Carotid artery injuries caused by blunt trauma. Ann Surg 192:7477, 1980 Perry MO, Snyder WH, Thal ER: Carotid artery injuries caused by blunt trauma. Ann Surg 192:74–77, 1980

    • Search Google Scholar
    • Export Citation
  • 16.

    Pozzati E, , Giuliani G, & Poppi M, et al: Blunt traumatic carotid dissection with delayed symptoms. Stroke 20:412416, 1989 Pozzati E, Giuliani G, Poppi M, et al: Blunt traumatic carotid dissection with delayed symptoms. Stroke 20:412–416, 1989

    • Search Google Scholar
    • Export Citation
  • 17.

    Pretre R, , Kursteiner K, & Reverdin A, et al: Blunt carotid artery injury: devastating consequences of undetected pseudoaneurysm. J Trauma 39:10121014, 1995 Pretre R, Kursteiner K, Reverdin A, et al: Blunt carotid artery injury: devastating consequences of undetected pseudoaneurysm. J Trauma 39:1012–1014, 1995

    • Search Google Scholar
    • Export Citation
  • 18.

    Sharma S, , Rajani M, & Mishra N, et al: Extracranial carotid artery aneurysms following accidental injury: ten years experience. Clin Radiol 43:162165, 1991 Sharma S, Rajani M, Mishra N, et al: Extracranial carotid artery aneurysms following accidental injury: ten years experience. Clin Radiol 43:162–165, 1991

    • Search Google Scholar
    • Export Citation
  • 19.

    Wholey MH, , Jarmolowski CR, & Eles G, et al: Endovascular stents for carotid occlusive disease. Radiology 201:244, 1996 (Abstract) Wholey MH, Jarmolowski CR, Eles G, et al: Endovascular stents for carotid occlusive disease. Radiology 201:244, 1996 (Abstract)

    • Search Google Scholar
    • Export Citation

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