Internal Carotid Artery Stenting for Blunt Carotid Artery Injuries With an Associated Pseudoaneurysm

Abstract

Carotid artery stenting is safe and effective initial therapy for patients with nonocclusive BCI and PA. Initial intermediate-term follow-up also fails to demonstrate significant morbidity for up to 4 years.

Comparison of conservative and operative treatment for blunt carotid injuries: Analysis of the National Trauma Data Bank

“…Given that BCI is rare and experience in the management of these injuries is limited, there is currently no consensus on the preferred treatment and it is not clear whether open surgical or endovascular interventions affect the outcome. [18][19][20] The aim of this study was to examine BCI using a large national database to better understand differences in hospital course and outcomes for patients who received conservative, operative, or endovascular treatments. Specifically, our goal was to compare the conservative management of BCI to operative treatment to determine differences in hospital length of stay, functional outcome, progression of original neurologic insult, and mortality.…”

Endovascular embolization for the treatment of right carotid-jugular arteriovenous fistula, with communicating left vertebral-right jugular arteriovenous fistula

“…Further evaluation of in-stent stenosis at follow up has been less clear. Cothren et al 10 reported a 45% re-stenosis rate of the native vessel on follow up compared with Berne et al 11 who reported a 14% re-stenosis rate. Interestingly, these rates are significantly higher than what Cothren et al 10 demonstrated in their conservatively managed population, which exhibited a 5% re-stenosis rate.…”

“…Furthermore, a case series of 33 patients described the use of the native vessel sacrifice and selective embolization in the management strategy for PA with resultant mixed outcomes. 11 Overall procedure-related complications were reported as 18%, but those patients who underwent vessel sacrifice had a complication rate of 33% including one death. Patients undergoing selective embolization had an associated complication rate of 16%.…”

Endovascular therapy of extracranial carotid artery pseudoaneurysms: case series and literature review

“…Stenosis or occlusion of stents occurred in 5.3% of lesions12 17 32 33 (table 6). Further endovascular therapy was required in three of 105 patients (2.9%) (table 6), consisting of placement of an additional stent31 36 and angioplasty of the left common femoral artery for decreased pulses postoperatively 12…”