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Penetrating carotid artery: uncommon complex and lethal injuries

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Abstract

Carotid arterial injuries are the most difficult and certainly the most immediately life-threatening injuries found in penetrating neck trauma. Their propensity to bleed actively and potentially occludes the airway and makes surgical intervention very challenging. Their potential for causing fatal neurological outcomes demands that trauma surgeons exercise excellent judgment in the approach to their definitive management. The purpose of this article is to review the diagnosis and management of these injuries.

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References

  1. Asensio JA, Valenziano CP, Falcone RE, Grosh JD. Management of penetrating neck injuries. The controversy surrounding Zone II injuries. In: Asensio JA, Weigelt JA, eds. Surgical clinics of North America, contemporary problems in trauma surgery, vol. 71, no. 2. Philadelphia: W.B. Saunders Co., 1991;267–96.

  2. Demetriades D, Asensio JA, Velmahos G, Thal E. Complex penetrating neck injuries. In: Asensio JA, Demetriades D, Berne TV, eds. Surgical clinics of North America. complex and challenging problems in trauma surgery, vol. 76, no. 4. Philadelphia: W.B. Saunders Co., 1996;685–724.

  3. Demetriades D, Theodorou D, Comwell EE, Beme TV, Asensio JA, Belzberg H, Velmahos G, Weaver F, Yellin A. Evaluation of penetrating injuries of the neck: a propective study of 223 patients. World J Surg. 1995;21:41–48.

    Google Scholar 

  4. Weaver FA, Yellin AE, Wagner WH, Brooks SH, Weaver AA, Milford MA. The role of arterial reconstruction in penetrating carotid injuries. Arch Surg. 1988;123:1106–11.

    PubMed  CAS  Google Scholar 

  5. Kuehne JP, Weaver FA, Papanicolaou G, Yellin AE. Penetrating trauma of the internal carotid artery. Arch Surg. 1996;131:942–8.

    PubMed  CAS  Google Scholar 

  6. Kuma SR, Weaver FA, Yellin AE Cervical vascular injuries. Carotid and jugular venous injuries. In: Asensio JA, Demetriades D, Feliciano DV, Hoyt DV, eds. Vascular trauma: complex and challenging injuries (Surgical clinics of North America), vol. 81, no. 6, part 1. Philadelphia: W.B. Saunders Co., 2002;1331–44.

  7. Cohen CA, Brief D, et al. Carotid artery injuries. An analysis of eighty-five cases. Am J Surg. 1970;120(2):210–4.

    Article  PubMed  CAS  Google Scholar 

  8. Bradley EL 3rd. Management of penetrating carotid injuries: an alternative approach. J Trauma. 1973;13(3):248–55.

    Article  PubMed  Google Scholar 

  9. Rubio PA, Reul GJ Jr, et al. Acute carotid artery injury: 25 years’ experience. J Trauma. 1974;14(11):967–73.

    Article  PubMed  CAS  Google Scholar 

  10. Thal ER, Snyder WH 3rd, et al. Management of carotid artery injuries. Surgery. 1974;76(6):955–62.

    PubMed  CAS  Google Scholar 

  11. Ledgerwood AM, Mullins RJ, et al. Primary repair vs ligation for carotid artery injuries. Arch Surg. 1980;115(4):488–93.

    PubMed  CAS  Google Scholar 

  12. Unger SW, Tucker WS Jr, et al. Carotid arterial trauma. Surgery. 1980;87(5):477–87.

    PubMed  CAS  Google Scholar 

  13. Demetriades D, Skalkides J, et al. Carotid artery injuries: experience with 124 cases. J Trauma. 1989;29(1):91–4.

    Google Scholar 

  14. Brown MF, Feliciano DV, et al. Carotid injuries. Am J Surg. 1982;144:748.

  15. Fry RE, Fry WJ. Extracranial carotid artery injuries. Surgery. 1980;88:581.

    Google Scholar 

  16. Richardson JD, Simpson C, et al. Management of carotid artery trauma. Surgery. 1988;104(4):673–80.

    PubMed  CAS  Google Scholar 

  17. Liekweg WC Jr, Greenfield LJ. Management of penetrating arterial injury. Ann Surg. 1978;188:587.

    Article  PubMed  Google Scholar 

  18. Ditmars ML, Klein SR, Bongard FS. Diagnosis and management of zone III carotid injuries. Injury. 1997;28(8):515–20.

    Article  PubMed  CAS  Google Scholar 

  19. Mittal VK, Paulson TJ, Colaiuta E, Habib FA, Penney DG, Daly B, Young SC. Carotid artery injuries and their management. J Cardiovasc Surg (Torino). 2000;41(3):423–31.

    CAS  Google Scholar 

  20. Navsaria P, Omoshoro-Jones J, Nicol A. An analysis of 32 surgically managed penetrating carotid artery injuries. Eur J Vasc Endovasc Surg. 2002;24(4):349–55.

    Article  PubMed  CAS  Google Scholar 

  21. Ferguson E, Dennis JW, Vu JH, Frykberg ER. Redefining the role of arterial imaging in the management of penetrating zone 3 neck injuries. Vascular. 2005;13(3):158–63.

    PubMed  Google Scholar 

  22. Nemzek WR, Hecht ST, Donald PJ, McFall RA, Poirier VC. Prediction of major vascular injury in patients with gunshot wounds to the neck. Am J Neuroradiol. 1996;17:161–7.

    PubMed  CAS  Google Scholar 

  23. Munera F, Soto JA, Palacio D, Velez SM, Medina E. Diagnosis of arterial injuries caused by penetrating trauma to the neck: comparison of helical CT angiography and conventional angiography. Radiology. 2000;216:356–62.

    PubMed  CAS  Google Scholar 

  24. Dossa C, Shepard AD, Wolford OG, et al. Distal internal carotid exposure. A simplified technique for temporary mandibular subluxation. J Vasc Surg. 1990;12:319.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Division of Trauma Surgery and Surgical Critical Care, Dewitt-Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Ryder Trauma Center, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA

    J. A. Asensio, T. Vu, F. N. Mazzini, F. Herrerias, G. D. Pust, J. Sciarretta, J. Chandler, J. M. Verde, P. Menendez, J. M. Sanchez, P. Petrone & C. Marini

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  1. J. A. Asensio
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  2. T. Vu
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  3. F. N. Mazzini
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  4. F. Herrerias
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  5. G. D. Pust
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  6. J. Sciarretta
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  7. J. Chandler
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  8. J. M. Verde
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  9. P. Menendez
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  10. J. M. Sanchez
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  11. P. Petrone
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  12. C. Marini
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Correspondence to J. A. Asensio.

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Asensio, J.A., Vu, T., Mazzini, F.N. et al. Penetrating carotid artery: uncommon complex and lethal injuries. Eur J Trauma Emerg Surg 37, 429–437 (2011). https://doi.org/10.1007/s00068-011-0132-3

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  • DOI: https://doi.org/10.1007/s00068-011-0132-3

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