Endovascular treatment of carotid injury

V.G. Martinakis, I. Dalainas, V.C. Katsikas, K. Xiromeritis

Department of Vascular Surgery, “G. Gennimatas” General Hospital, Athens, Greece. dalainas@freemail.gr

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• Angiology

This is a systematic review of the International Literature regarding the role of endovascular treatment in cases of carotid injury.
Injury to the carotid artery is not very common but is a serious consequence associated with either blunt or penetrating cervical trauma. They are difficult to evaluate due to associated injuries. The frequent coexistence of traumatic brain injuries seems to obscure its presentation and concurrent systemic injuries make the management somewhat challenging from the perspective of both diagnosis and treatment. Although bleeding is a serious and potentially fatal complication of these injuries, the main concern should be the impairment of cerebral blood supply. In the modern era of increasing usage of minimally invasive treatment options and technological advances, endovascular approach seems to gain acceptance as a sufficient alternative treatment modality in carefully selected groups of these trauma population. Interesting issues facing this emerging technology include the adequate definition of the types of injuries ideally indicated for endovascular treatment. Those traumatic carotid lesions located proximal to aortic arch or near the skull base are particularly hazardous to approach and difficult to repair surgically and may benefit of an endovascular approach. Specifically, iatrogenic injuries of carotid vessels are often occur in patients with significant comorbidities that make their management challenging.

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