Management of Blunt Injury to the Internal Carotid Artery
作者:
RICHARD WELLING,
THOMAS SAUL,
JOHN TEW,
THOMAS TOMSICK,
TIMOTHY KREMCHEK,
MARY BELLAMY,
期刊:
The Journal of Trauma: Injury, Infection, and Critical Care
(OVID Available online 1987)
卷期:
Volume 21,
issue 11
页码: 1221-1226
ISSN:0022-5282
年代: 1987
出版商: OVID
数据来源: OVID
摘要:
The management of vascular injury to the internal carotid artery (ICA) is controversial. We undertook a retrospective review of 14 patients with blunt injuries to the ICA and found three types of ICA injury, often presenting with delayed symptomatology. Six patients had intraluminal arterial stenosis or obstruction and were treated with anticoagulants. Five patients had pseudoaneurysms. Three of these were treated with balloon occlusion of the ICA above and below the orifice of the aneurysm, one with aneurysmorrhaphy, and one with resection and interposition vein graft. Three patients sustained a carotid cavernous fistula and were treated by balloon occlusion of the fistula while patency of the ICA was maintained. Treatment rendered all patients either asymptomatic or with residual deficits only.Angiography is essential to anatomically delineate the injury. The vascular surgeon, the neurosurgeon, and the interventional radiologist all make important contributions to the successful treatment of patients with blunt ICA injuries.
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