Successful endovascular therapy of a penetrating zone III internal carotid injury

McNeil, Jeffrey D.; Chiou, Andy C.; Gunlock, Michael G.; Grayson, David E.; Soares, Gregory M.; Hagino, Ryan T.

doi:10.1067/mva.2002.125020

Cited by 56 publications

(45 citation statements)

References 7 publications

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“…However, HCTA may be used as a triage method for selecting patients to undergo endovascular therapy such as embolization, prosthesis placement, or temporary vascular occlusion versus surgical therapy. [47][48][49][50][51][52] Further studies are needed to clarify this point.…”

Section: Limitations and Pitfallsmentioning

confidence: 99%

Penetrating Injuries of the Neck: Use of Helical Computed Tomographic Angiography

Múnera

Cohn

Rivas

2005

The Journal of Trauma: Injury, Infection, and Critical Care

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The diagnostic evaluation of stable patients with penetrating trauma to the neck remains controversial. Conventional angiography has traditionally been considered the gold standard for evaluation of vascular injuries. The use of angiography for stable patients with penetrating neck trauma has been questioned because of its invasive nature and reported low yield. In recent years, there has been a renewed interest in the use of noninvasive techniques such as helical computed tomographic (CT) angiography for the evaluation of these patients. Helical CT angiography, a low-risk, rapid, accurate, noninvasive, reproducible technique, is less expensive than conventional angiography. Helical CT angiography also can provide information about potential lesions of associated vital structures such as the cervical spine and the aerodigestive tract. This review evaluates the authors' current protocol for penetrating neck wounds and identifies indications for helical CT angiography.

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Section: Limitations and Pitfallsmentioning

confidence: 99%

Penetrating Injuries of the Neck: Use of Helical Computed Tomographic Angiography

Múnera

Cohn

Rivas

2005

The Journal of Trauma: Injury, Infection, and Critical Care

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“…8 Endovascular procedures, including stents or balloon occlusion, may have a role in the acute trauma setting although the majority of the reported experience is with the treatment of pseudoaneurysms. [9][10][11] But, the endovascular approach does avoid the difficulties of surgical access for vascular control at the skull base. In general, preoperative coma is a contraindication to arterial revascularization given the high incidence of severe reperfusion injury associated with such maneuvers.…”

Section: Discussionmentioning

confidence: 99%

Penetrating Temporal Bone Trauma

Kilty

Murphy²

2009

Journal of Trauma: Injury, Infection &Amp; Critical Care

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T emporal bone injury overall is an infrequent presentation. In patients presenting with head trauma, only 5% have a temporal bone fracture. 1 Mechanisms of temporal bone trauma are divided into blunt and penetrating. Penetrating injuries of the temporal bone are less common than blunt injuries, but are likely to be more damaging. 2 Penetrating injuries are of two types: stab injuries and gunshot injuries. 3 Either injury may be limited to the temporal bone or involve other cranial structures. These injuries often require a team approach to management. CaseA 38-year-old man was transferred from a peripheral hospital to our trauma center after sustaining a gunshot wound to the head. The patient was awake, alert, and oriented with a Glasgow coma score (GCS) of 15, but a noncooperative historian. The patient was examined and was found to have an entrance wound posterior to the left auricle over the mastoid with scorching of the posterior pinna ( Fig. 1). A focused neurologic examination revealed a House-Brackmann grade 2 left facial weakness, with minimal weakness of the frontal branch of the left facial nerve. There was right beating nystagmus present only on rightward gaze (first-degree nystagmus). The left external auditory canal (EAC) was draining a mixture of blood and cerebrospinal fluid (CSF).A high-resolution computed tomography (HRCT) scan of the temporal bone revealed a mixed fracture of the left temporal bone with an adjacent subdural hematoma (SDH), temporal lobe contusion, and pneumocephalus (Fig. 2). A fracture line extended through the basal turn of the cochlea and the vestibule. The bullet had fractured into two main fragments; one was situated in the superficial lobe of the left parotid gland, the other was in the left mastoid adjacent to the sigmoid sinus extending anteriorly to the middle ear space and the posterior wall of the external auditory canal (Figs. 3 and 4).The patient was taken to the operating room where a left simple mastoidectomy was performed for removal of the mastoid bullet fragment (Fig. 5). This involved an exenteration of the central mastoid air cells with preservation of the posterior EAC wall and without modification to the EAC. A dural tear was situated in the region of the tegmen. Through this tear, the SDH was evacuated with subsequent suture closure of the dural tear, which was then reinforced with a temporalis muscle flap. Postoperatively, the patient developed CSF drainage from the bullet entry site that was resistant to treatment with a lumbar drain. This CSF leak was then subsequently closed using a middle cranial fossa approach to place a fascia lata graft. The patient was discharged from hospital shortly after this procedure without any evidence of a subsequent leak. An audiogram performed in follow-up revealed a profound hearing loss in the left ear. DISCUSSIONTemporal bone injury occurs in 20% to 50% of gunshot wounds to the head. 3,4 These injuries most commonly are not self-inflicted. Gunshots can be either of low velocity (90 -210 m/s) or high velocity (Ͼ610 m...

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“…In-stent stenosis due to intimal hyperplasia was described in an additional three cases of traumatic ICA pseudoaneurysms,[347379] as also one case of a VA pseudoaneurysm with multiple AVFs. [92] McNeil et al .,[73] and Flood et al .,[34] each reported 50% ICA in-stent stenosis following placement of a Wallgraft and Jostent at 10 months and one year, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…These publications are summarized in Table 1. [12457811131516192527–3234353738414245495152545759–63656668–7375–77798082–858789–9294–98100101103104106109112–114]…”

Section: Review Of the Literaturementioning

confidence: 99%

Endovascular implantation of covered stents in the extracranial carotid and vertebral arteries: Case series and review of the literature

Alaraj¹,

Wallace²,

Amin‐Hanjani³

et al. 2011

Surg Neurol Int

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Background:Covered stents are used endovascularly to seal arterial wall defects while preserving vessel patency. This report describes our experience with the use of covered stents to treat cervical pathology, and a review of the literature in regards to this topic is presented.Case Description:Two patients presenting with the carotid blowout syndrome and one patient with a vertebrojugular fistula were treated with covered stents. This allowed for preservation of the vessel and was a treatment alternative to cerebral bypass.Conclusion:Covered stents provide a viable means of preserving the cervical vessels in selected patients; however, long-term follow-up is necessary to determine stent patency and permanency of hemostasis.

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Successful endovascular therapy of a penetrating zone III internal carotid injury

Cited by 56 publications

References 7 publications

Penetrating Injuries of the Neck: Use of Helical Computed Tomographic Angiography

Penetrating Injuries of the Neck: Use of Helical Computed Tomographic Angiography

Penetrating Temporal Bone Trauma

Endovascular implantation of covered stents in the extracranial carotid and vertebral arteries: Case series and review of the literature

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