Epidemiology, repair technique, and predictors of stroke and mortality in penetrating carotid artery injuries

Plotkin, Anastasia; Owattanapanich, Natthida; Byerly, Saskya; Schellenberg, Morgan; Inaba, Kenji; Magee, Gregory A.

doi:10.1016/j.jvs.2023.06.019

Cited by 2 publications

(1 citation statement)

References 15 publications

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“…To identify management strategies that may mitigate stroke or mortality, multivariate logistic regression was performed using clinically known risk factors as covariates. [18][19][20][21][22] Effect sizes were reported as odds ratios (ORs) with 95% CI. All continuous predictor variables were confirmed to have <9% missing data, which were replaced with the adjusted series median.…”

Section: Discussionmentioning

confidence: 99%

Management Patterns and Outcomes After Traumatic Brain Injury With Associated Blunt Cerebrovascular Injury

Findlay,

Sarriera-Valentin,

Earl

et al. 2023

Neurosurgery

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BACKGROUND AND OBJECTIVES: Although blunt cerebrovascular injuries (BCVIs) are relatively common in patients with traumatic brain injuries (TBIs), uncertainty remains regarding optimal management strategies to prevent neurological complications, morbidity, and mortality. Our objectives were to characterize common care patterns; assess the prevalence of adverse outcomes, including stroke, functional deficits, and death, by BCVI grade; and evaluate therapeutic approaches to treatment in patients with BCVI and TBI. METHODS: Patients with TBI and BCVI treated at our Level I trauma center from January 2016 to December 2020 were identified. Presenting characteristics, treatment, and outcomes were captured for univariate and multivariate analyses. RESULTS: Of 323 patients with BCVI, 145 had Biffl grade I, 91 had grade II, 49 had grade III, and 38 had grade IV injuries. Lower-grade BCVIs were more frequently managed with low-dose (81 mg) aspirin (P < .01), although all grades were predominantly treated with high-dose (150-600 mg) aspirin (P = .10). Patients with low-grade BCVIs had significantly fewer complications (P < .01) and strokes (P < .01). Most strokes occurred in the acute time frame (<24 hours), including 10/11 (90.9%) grade IV-related strokes. Higher BCVI grade portended elevated risk of stroke (grade II odds ratio [OR] 5.3, grade III OR 12.2, and grade IV OR 19.6 compared with grade I; all P < .05). The use of low- or high-dose aspirin was protective against mortality (both OR 0.1, P < .05). CONCLUSION: In patients with TBI, BCVIs impart greater risk for stroke and other associated morbidities as their severity increases. It may prove difficult to mitigate high-grade BCVI-related stroke, considering most events occur in the acute window. The paucity of late time frame strokes suggest that current management strategies do help mitigate risks.

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Section: Discussionmentioning

confidence: 99%

Management Patterns and Outcomes After Traumatic Brain Injury With Associated Blunt Cerebrovascular Injury

Findlay,

Sarriera-Valentin,

Earl

et al. 2023

Neurosurgery

View full text Add to dashboard Cite

show abstract

Double trouble! penetrating injury to the internal carotid artery and internal jugular vein repaired with non-reversed saphenous vein interposition graft: A case report

Epidemiology, repair technique, and predictors of stroke and mortality in penetrating carotid artery injuries

Cited by 2 publications

References 15 publications

Management Patterns and Outcomes After Traumatic Brain Injury With Associated Blunt Cerebrovascular Injury

Management Patterns and Outcomes After Traumatic Brain Injury With Associated Blunt Cerebrovascular Injury

Double trouble! penetrating injury to the internal carotid artery and internal jugular vein repaired with non-reversed saphenous vein interposition graft: A case report

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