A modern approach to cervical vascular trauma.

Published

Journal Article (Review)

Blunt or penetrating trauma to the major arteries of the neck are challenging problems, however, newer diagnostic and therapeutic modalities have simplified care and largely eliminated the need for diagnostic neck exploration. High-quality computed tomographic angiography is quick and sensitive, identifying the vast majority of injuries prior to any operative intervention. Even in cases where active exsanguination or impending airway compromise mandates immediate exploration, intraoperative imaging and endovascular interventions have largely supplanted relatively morbid exposures for open repair. Traditional open repair of carotid injuries with primary closure or interposition grafting is effective over the long term and is always recommended if proximal and distal control can be achieved in a safe and straightforward manner. Endovascular repair of the proximal carotid, proximal subclavian, and distal internal carotid arteries is increasingly accepted. However, vertebral trauma is dealt with almost exclusively by endovascular means. Recent military experiences in Iraq and Afghanistan highlight the imaging-intensive management of cervical vascular trauma and demonstrate the effectiveness of computed tomography angiography, selective arteriography, and endovascular interventions.

Full Text

Duke Authors

Cited Authors

  • O'Brien, PJ; Cox, MW

Published Date

  • 2011-06-01

Published In

Volume / Issue

  • 23 / 2

Start / End Page

  • 90 - 97

PubMed ID

  • 21986686

Pubmed Central ID

  • 21986686

Electronic International Standard Serial Number (EISSN)

  • 1521-5768

Digital Object Identifier (DOI)

  • 10.1177/1531003511408337

Language

  • eng

Conference Location

  • United States