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Arteries of the Head and Neck01:26

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The human body's intricate network of arteries ensures that every organ system receives the necessary oxygen and nutrients for optimal function. The arterial network in the head and neck region is particularly complex, providing vital blood flow to the brain, eyes, and other critical structures. Prominent arteries in this region include the internal carotid arteries and the vertebral arteries.
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Updated: Jan 18, 2026

A Rat Carotid Artery Pressure-Controlled Segmental Balloon Injury with Periadventitial Therapeutic Application
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Exploring penetrating carotid Injuries: Low grade, low yield?

Victoria Wagner1, Vanessa Arientyl1, Alejandro De Leon Castro2

  • 1Emory University School of Medicine, 100 Woodruff Circle, Atlanta, GA, 30322, USA.

American Journal of Surgery
|June 5, 2025
PubMed
Summary

Mandatory repair of low-grade penetrating carotid injuries is not always necessary. Non-operative management showed similar stroke rates to surgical repair, suggesting CT imaging for stable patients with penetrating neck trauma.

Keywords:
Non-operative managementPenetrating carotid injuryStrokeTraumatic injuryVascular trauma

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Area of Science:

  • Vascular Surgery
  • Trauma Management
  • Diagnostic Imaging

Background:

  • The necessity of surgical intervention for low-grade penetrating carotid injuries remains debated.
  • Current guidelines lack clarity on optimal management strategies.

Purpose of the Study:

  • To compare outcomes between non-operative and operative management of low-grade penetrating carotid injuries.
  • To evaluate the safety and efficacy of non-operative approaches.

Main Methods:

  • Retrospective review of 54 patients with 62 low-grade penetrating injuries (intimal dissections, intramural hematomas) of the common carotid artery (CCA) and internal carotid artery (ICA).
  • Comparison of outcomes for patients managed non-operatively versus operatively.
  • Data collected from January 2012 to December 2023.

Main Results:

  • Operative management (10 patients) primarily involved non-therapeutic vascular explorations (90%).
  • One death occurred in the operative group due to neurologic decline.
  • No deaths or strokes were reported in the non-operative group (44 patients).
  • Stroke rates were comparable between both management groups.

Conclusions:

  • Non-operative management of low-grade penetrating carotid injuries is a safe alternative with similar stroke rates to operative repair.
  • CT imaging is recommended for stable patients with penetrating neck trauma to accurately characterize injuries.
  • Non-operative management may avoid unnecessary surgical interventions and associated risks.