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Related Experiment Videos

Cervical vascular injuries: a trauma center experience

P M Rao1, R R Ivatury, P Sharma

  • 1Department of Surgery, Lincoln Medical and Mental Health Center, Bronx, NY 10451.

Surgery
|September 1, 1993
PubMed
Summary

Routine angiography is crucial for diagnosing and managing penetrating neck trauma, especially in zones I and III. Prompt repair of carotid artery injuries and selective ligation for internal carotid artery injuries improve patient outcomes.

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Area of Science:

  • Vascular Surgery
  • Trauma Management
  • Diagnostic Imaging

Background:

  • Analysis of 76 patients with cervical vascular injuries from penetrating neck trauma.
  • Study conducted between 1977 and 1990 at a level I trauma center.
  • Evaluation of angiography's role in diagnosis and management of neck trauma.

Purpose of the Study:

  • To evaluate the role of angiography in the diagnosis and management of cervical vascular injuries.
  • To assess the course and outcome of patients with penetrating neck trauma.
  • To determine optimal surgical and interventional strategies.

Main Methods:

  • Hemodynamically unstable patients underwent immediate surgical exploration.
  • Stable patients received diagnostic investigation, including routine angiography for zones I and III.

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  • Therapeutic embolization performed during angiography; other injuries treated surgically.

    • Main Results:

    • Hemorrhage was the leading cause of death (15.8%) in patients with vascular injury.
    • Angiography diagnosed vascular injuries in hemodynamically stable patients in zones I and III.
    • Common and internal carotid artery injuries were repaired, often with grafts; selective ligation was successful in some cases.

    Conclusions:

    • Routine angiography in zones I and III is recommended for penetrating neck trauma.
    • Repair of common and internal carotid artery injuries is advised.
    • Ligation of the internal carotid artery is a viable option without preoperative neurologic deficit.