Document Detail


A modern approach to cervical vascular trauma.
MedLine Citation:
PMID:  21986686     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Blunt or penetrating trauma to the major arteries of the neck are challenging problems, however, newer diagnostic and therapeutic modalities have simplified care and largely eliminated the need for diagnostic neck exploration. High-quality computed tomographic angiography is quick and sensitive, identifying the vast majority of injuries prior to any operative intervention. Even in cases where active exsanguination or impending airway compromise mandates immediate exploration, intraoperative imaging and endovascular interventions have largely supplanted relatively morbid exposures for open repair. Traditional open repair of carotid injuries with primary closure or interposition grafting is effective over the long term and is always recommended if proximal and distal control can be achieved in a safe and straightforward manner. Endovascular repair of the proximal carotid, proximal subclavian, and distal internal carotid arteries is increasingly accepted. However, vertebral trauma is dealt with almost exclusively by endovascular means. Recent military experiences in Iraq and Afghanistan highlight the imaging-intensive management of cervical vascular trauma and demonstrate the effectiveness of computed tomography angiography, selective arteriography, and endovascular interventions.
Authors:
P Joshua O'Brien; Mitchell W Cox
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Perspectives in vascular surgery and endovascular therapy     Volume:  23     ISSN:  1521-5768     ISO Abbreviation:  Perspect Vasc Surg Endovasc Ther     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-10-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100970607     Medline TA:  Perspect Vasc Surg Endovasc Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  90-7     Citation Subset:  IM    
Affiliation:
1Duke University Medical Center, Durham, NC, USA.
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