Conclusions:In the LE group there were significantly more complications, greater mean overall hospital and ICU length of stay and higher mortality. Lower extremities required more intensive intervention compared to upper extremities: there were more fasciotomies, complex soft tissue repairs and major amputations performed. Those patients with blunt mechanism of injury, regardless of the extremity, also had higher rates of these procedures as well as significantly higher complication and mortality rates compared to those with penetrating injury.

microemboli was significantly higher in CAS group than CEA group (46.3% and 12% respectively, PϽ0.05) despite a relative low incidence of associated neurologic symptoms (2.6 % vs. 2%). Thirty patients (16 CAS and 14 CEA) with 50 DWI lesions (mean size 46.57mm 2 , ranging 16 to 128mm 2 ) were further analyzed. During a mean MRI follow-up of 10 months (range, 2 to 23 months), residual MRI abnormalities were only identified in DWI lesions larger than 60mm 2 (nϭ5, PϽ0.001). CEA group had fewer but larger ipsilaterally distributed emboli (total 12 lesions, mean 79mm 2 ) comparing to CAS group (total 38 lesions, mean 27.5mm 2 , PϽ0.05). Regression analyses of 68 CAS patients (mean age 71 years, range, 53-91 years) showed that date of procedure prior to 1/2007, coronary artery disease, diabetes, and perioperative troponin elevation were significant predictors of microemboli (PϽ0.03). Date of procedure was the only predictor of bilateral hemispheres microemboli (pϭ0.025).Conclusions: Carotid interventions are associated with significant DWI lesions despite absence of clinical symptoms. Risks of microemboli correlate to physician experience and patient selection. Larger DWI lesions (Ͼ60mm 2 ) can lead to long-term residual structure abnormalities that warrants further neurocognitive evaluation.