Antiaggregation Versus Anticoagulation for Stroke, Bleeding, and Mortality in Patients With Blunt Carotid Injury: A...

Area of Science:

• Vascular Surgery
• Trauma Surgery
• Neurology

Background:

• Blunt carotid artery injuries are associated with a significant risk of stroke.
• Current management strategies involve antiplatelet or anticoagulation therapy, but optimal choice remains debated.

Purpose of the Study:

• To compare the effectiveness and safety of antiplatelet therapy versus anticoagulation therapy in preventing stroke following blunt carotid injuries.

Main Methods:

• A systematic literature search was conducted across Medline, Central, and Embase.
• Data were extracted from randomized controlled trials, controlled clinical trials, and nonrandomized studies.
• Primary outcomes included stroke, transient ischemic attack, and mortality; secondary outcomes included major extracranial bleeding.

Main Results:

• Three studies comprising 796 patients met the inclusion criteria.
• No significant differences were found between antiplatelet and anticoagulation therapies regarding stroke, transient ischemic attack, or major bleeding.
• Odds ratios for stroke [1.13, 95% CI, 0.30-4.24], TIA [1.01, 95% CI, 0.14-6.59], and major bleeding [0.94, 95% CI, 0.02-2.77] were not statistically significant.

Conclusions:

• Current evidence suggests no significant difference in effectiveness or safety between antiplatelet and anticoagulation therapies for blunt carotid injuries.
• Further high-quality studies are required to guide optimal therapeutic recommendations, including drug choice, dosage, and timing.