[Gunshot trauma to the common carotid artery]

A case of gunshot trauma to the common carotid artery which presented with a juxtaclavicular pulsating hematoma is presented. After precise diagnosis was established by angiography, reconstruction by interposing and autologous saphenous vein graft was successful. Aspects of this highly lethal type of trauma include the need for close observation of the asymptomatic patient, indications for exploring penetrating neck trauma, the need for routine angiography and reconstructive arterial surgery in the presence of central neurological damage, relevant surgical techniques, and the availability of parasurgical facilities. The current consensus is to perform reconstructive arterial surgery when feasible, regardless of preoperative neurological status. Preoperative angiography is definitely recommended in any hemodynamically stable patient who is not suffocating. An aggressive approach, surgical expertise and perioperative support might reverse the poor prognosis in these otherwise fatal cases.