Korean J Crit Care Med.  2017 Aug;32(3):297-301. 10.4266/kjccm.2017.00010.

Endovascular Stenting for the Treatment of an Initially Asymptomatic Patient with Traumatic Carotid Artery Dissection

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea. pjcook@jejunu.ac.kr

Abstract

No abstract available.


MeSH Terms

Carotid Arteries*
Humans
Stents*

Figure

  • Figure 1. Neck computed tomography scan showing dissections of both common carotid arteries, mid portion. (A) The 2.6-cm segmental intimal flap in the left common carotid artery. (B) A short segmental intimal flap in the right common carotid artery. (C) Diffuse hematoma around the thyroid gland in the anterior neck. (D) Coronal view showing both common carotid artery dissections.

  • Figure 2. Brain diffusion magnetic resonance image showing a tiny diffusion-restricted lesion in the left frontal white matter. Multiple tiny high signal intensities in both cerebral white matter.

  • Figure 3. Transfemoral cerebral angiography showing dissection of both distal common carotid arteries. (A) A movable flap was observed according to flow in the left common carotid artery without thrombus. (B) Flow patent after stent insertion in the left common carotid artery. (C) A movable flap was observed according to flow in the right common carotid artery without thrombus. (D) Flow patent after stent insertion in the right common carotid artery.


Reference

References

1. Jansen G, Popp J, Dietrich U, Mertzlufft F, Bach F. Traumatic dissection of the carotid artery: challenges for diagnostics and therapy illustrated by a case example. Anaesthesist. 2013; 62:817–23.
2. Baker WE, Wassermann J. Unsuspected vascular trauma: blunt arterial injuries. Emerg Med Clin North Am. 2004; 22:1081–98.
Article
3. Cohen JE, Ben-Hur T, Gomori JM, Umansky F, Lylyk P, Rajz G. Stent-assisted arterial reconstruction of traumatic extracranial carotid dissections. Neurol Res. 2005; 27 Suppl 1:S73–8.
Article
4. Fateri F, Groebli Y, Rufenacht DA. Intraarterial thrombolysis and stent placement in the acute phase of blunt internal carotid artery trauma with subocclusive dissection and thromboembolic complication: case report and review of the literature. Ann Vasc Surg. 2005; 19:434–7.
Article
5. Yang ST, Huang YC, Chuang CC, Hsu PW. Traumatic internal carotid artery dissection. J Clin Neurosci. 2006; 13:123–8.
Article
6. Biffl WL, Ray CE Jr, Moore EE, Franciose RJ, Aly S, Heyrosa MG, et al. Treatment-related outcomes from blunt cerebrovascular injuries: importance of routine follow-up arteriography. Ann Surg. 2002; 235:699–706.
7. Biffl WL, Cothren CC, Moore EE, Kozar R, Cocanour C, Davis JW, et al. Western Trauma Association critical decisions in trauma: screening for and treatment of blunt cerebrovascular injuries. J Trauma. 2009; 67:1150–3.
Article
8. Bromberg WJ, Collier BC, Diebel LN, Dwyer KM, Holevar MR, Jacobs DG, et al. Blunt cerebrovascular injury practice management guidelines: the Eastern Association for the Surgery of Trauma. J Trauma. 2010; 68:471–7.
Article
9. Biffl WL, Moore EE, Offner PJ, Brega KE, Franciose RJ, Burch JM. Blunt carotid arterial injuries: implications of a new grading scale. J Trauma. 1999; 47:845–53.
Article
10. Wahl WL, Brandt MM, Thompson BG, Taheri PA, Greenfield LJ. Antiplatelet therapy: an alternative to heparin for blunt carotid injury. J Trauma. 2002; 52:896–901.
Article
11. Moulakakis KG, Mylonas S, Avgerinos E, Kotsis T, Liapis CD. An update of the role of endovascular repair in blunt carotid artery trauma. Eur J Vasc Endovasc Surg. 2010; 40:312–9.
Article
12. Cafasso D, Meadows JM, Wolfe SQ, Katras T, Kellicut DC, Golarz SR. Endovascular treatment of bilateral carotid artery pseudoaneurysms after blunt carotid injury. Ann Vasc Surg. 2014; 28:263.e11–6.
Article
13. Cothren CC, Biffl WL, Moore EE, Kashuk JL, Johnson JL. Treatment for blunt cerebrovascular injuries: equivalence of anticoagulation and antiplatelet agents. Arch Surg. 2009; 144:685–90.
Article
14. Griessenauer CJ, Fleming JB, Richards BF, Cava LP, Cure JK, Younan DS, et al. Timing and mechanism of ischemic stroke due to extracranial blunt traumatic cerebrovascular injury. J Neurosurg. 2013; 118:397–404.
Article
15. Scott WW, Sharp S, Figueroa SA, Eastman AL, Hatchette CV, Madden CJ, et al. Clinical and radiographic outcomes following traumatic grade 1 and 2 carotid artery injuries: a 10-year retrospective analysis from a level I trauma center. The Parkland Carotid and Vertebral Artery Injury Survey. J Neurosurg. 2015; 122:1196–201.
Article
16. Eastman AL, Muraliraj V, Sperry JL, Minei JP. CTA-based screening reduces time to diagnosis and stroke rate in blunt cervical vascular injury. J Trauma. 2009; 67:551–6.
Article
17. Li W, D’Ayala M, Hirshberg A, Briggs W, Wise L, Tortolani A. Comparison of conservative and operative treatment for blunt carotid injuries: analysis of the National Trauma Data Bank. J Vasc Surg. 2010; 51:593-9.e1–2.
Article
18. Mayberry JC, Brown CV, Mullins RJ, Velmahos GC. Blunt carotid artery injury: the futility of aggressive screening and diagnosis. Arch Surg. 2004; 139:609–12.
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