Study Supports Endovascular Treatment for Extracranial Carotid Artery Injuries

January 3, 2011—In the Journal of Vascular and Interventional Radiology, Diego A. Herrera, MD, et al published findings from a study that was conducted to describe the clinical and angiographic results of endovascular therapy for traumatic injuries of the extracranial carotid artery (2011;22:28–33).

The investigators concluded that in this series, endovascular techniques were an effective method of treatment. It was possible to use different endovascular reconstructive techniques or parent artery occlusion, depending on the degree of vessel damage, with resolution of clinical symptoms and avoidance of surgery in most cases.

In the study, the investigators reviewed the clinical and angiographic features of 36 traumatic injuries of the carotid artery during a 12-year period. There were 35 male patients (97.2%) and one female patient (2.8%), with an average age of 28.8 years (range 13–60 years). Of the 36 lesions of the carotid artery, 29 (80.6%) were the result of gunshot injury, and seven (19.4%) were secondary to stab wounds. In 24 (66.7%) instances, the injury resulted in a pseudoaneurysm; in seven (19.4%), an arteriovenous fistula; in four (11.1%), a dissection; and in one (2.8%), inactive bleeding. All patients were treated with an endovascular approach using different techniques (balloon occlusion, embolization, or stent deployment).

The investigators reported that endovascular therapy resulted in documented lesion occlusion in 34 patients (94.4%). Two patients declined any follow-up postprocedural imaging; however, they have remained asymptomatic. Clinical improvement was documented in 35 patients (97.2%), and there was one procedure-related complication with fatal consequences.