The Selective Non‐operative Management of Penetrating Cervical Venous Trauma is Safe and Effective

Madsen, Andre S.; Bruce, John; Oosthuizen, George; Bekker, W; Laing, G L; Clarke, Damian

doi:10.1007/s00268-018-4595-9

Cited by 14 publications

(28 citation statements)

References 27 publications

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“…However, no studies have reported on the endovascular evaluation of the venous system in penetrating neck trauma. 4 To the best of our knowledge, the present study is the first to report a total endovascular approach to penetrating trauma to zone II of the neck. This novel approach was developed by the senior author (E.A.).…”

mentioning

confidence: 71%

“…However, none the patients in the series underwent endovascular treatment. 4 In our patient, we were able to image all three segments of the venous system to exclude a penetrating injury without resorting to open operative management. Had significant venous injury been identified, traditional open neck exploration would have been warranted to appropriately address the injury.…”

Section: Discussionmentioning

confidence: 94%

“…In one series of patients admitted for penetrating neck injuries, <10% had had any venous injury and only 2.9% had had both venous and arterial injuries. 4 Approximately one half (51.3%) of the patients required operative management, usually for an associated injury. However, none the patients in the series underwent endovascular treatment.…”

Section: Discussionmentioning

confidence: 99%

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Explore no more: Early experience with a novel minimally invasive approach to penetrating trauma to zone II of the neck

Kaslow

Gurney

Ascher

2020

Journal of Vascular Surgery Cases, Innovations and Techniques

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The traditional approach to penetrating injuries to zone II of the neck has included operative neck exploration, extensive enough to allow for proximal and distal vascular control of the potential vascular injury. Few studies have reported cases of entirely endovascular management of penetrating injury to this portion of the neck. In the present case report, we describe the case of a 38-year-old man who had sustained a stab wound to zone II of the neck. The injury to the internal carotid artery was managed endovascularly with placement of a covered stent. The findings from the present case illustrate the potential use of minimally invasive vascular treatment strategies as an alternative to mandated operative intervention.

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mentioning

confidence: 71%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Explore no more: Early experience with a novel minimally invasive approach to penetrating trauma to zone II of the neck

Kaslow

Gurney

Ascher

2020

Journal of Vascular Surgery Cases, Innovations and Techniques

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“…Many international studies lack the significant numbers of patients seen in the south african trauma setting [1][2][3][4][5][6][7][8][9][10][11][12]. Madsen et al, published several studies focusing on penetrating neck injuries in the Pietermaritzburg metro area [13][14][15][16]. studies from cape town have also been published analysing the incidence and results of patients with penetrating neck trauma including the use of balloon tamponade [17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Results of Selective Non-Operative Management for Penetrating Neck Trauma in 594 patients.

Laher¹,

Monzon²,

Mauser³

2023

AJTES

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Background: The management of penetrating neck trauma (PNT) evolved from a policy of mandatory exploration to one of selective non-operative management (SNOM) based on clinical examination, and the liberal use of Computed Tomography Angiography (CTA) irrespective of the zone of injury for those patients who are stable on presentation. Methods: A retrospective audit of patients with penetrating neck injuries managed at Chris Hani Baragwanath Academic Hospital (CHBAH) Trauma Unit, from 2010 to 2015 was conducted. Statistical analysis was performed for all collected variables. A p-value of ≤ 0.05 was considered statistically significant. Results: The results of treatment of 594 patients were reviewed. There was a predominance of young males (93.4%) with a median age of 28 years (IQR 18-67) presenting with injuries in zone 2, left side of the neck, commonly due to stab wounds (89.3%). Immediate surgical exploration was needed in 145(24.4%), while the remaining (75.4%) were investigated with CTA. CTA showed a sensitivity and specificity of over 90% for vascular injuries and more than 80% for aerodigestive injuries. Major vascular injuries were the most common surgical finding. The overall negative exploration rate was 6%, and the mortality 2.5%. Conclusions: Our unit’s SNOM protocol relies on liberal CTA use. Despite the obvious limitations of a retrospective study our results showed an acceptable negative and non-therapeutic exploration rate and a low incidence of complications and mortality.

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“…Las venas constituyen las estructuras más comprometidas en lesiones penetrantes de cuello, pudiendo tener un manejo no quirúrgico selectivo, en comparación con las arteriales, que no ceden en su sangrado debido a la presión de las arterias 6 . El trauma laringotraqueal es igualmente raro, aproximadamente 1 caso por cada 30,000 pacientes que ingresan al Servicio de Urgencias.…”

Section: Introductionunclassified

Manejo de lesión traqueoesofágica completa con anastomosis esofágica y traqueal terminoterminal más esofagostomía con colocación de sonda en T

Reyes-Carrillo¹,

Villela-Cañas²,

Padilla-López³

et al. 2021

RHJM

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Las lesiones traumáticas de esófago tienen una prevalencia menor del 1% y el trauma laringotraqueal representa aproximadamente 1 caso por 30,000 pacientes en el Servicio de Urgencias. Caso clínico: Paciente de sexo masculino de 33 años de edad, sin antecedentes de importancia, el cual acude a urgencias tras autolesionarse con arma blanca a nivel de cuello, se estabiliza y posteriormente ingresa a cirugía urgente para exploración de cuello y reparación de tráquea y esófago. Conclusión: Las lesiones traqueoesofágicas tienen alta mortalidad, su manejo es un desafío para el equipo quirúrgico.

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The Selective Non‐operative Management of Penetrating Cervical Venous Trauma is Safe and Effective

Abstract: SNOM is applicable to a well-defined subset of patients with isolated penetrating cervical venous trauma to the IJV and SCV identified on CTA.

Cited by 14 publications

References 27 publications

Explore no more: Early experience with a novel minimally invasive approach to penetrating trauma to zone II of the neck

Explore no more: Early experience with a novel minimally invasive approach to penetrating trauma to zone II of the neck

Results of Selective Non-Operative Management for Penetrating Neck Trauma in 594 patients.

Manejo de lesión traqueoesofágica completa con anastomosis esofágica y traqueal terminoterminal más esofagostomía con colocación de sonda en T

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