Shotgun wound and pellet embolism to the intracranial carotid artery

Vaquero-Puerta, Carlos; Norberto, Enrique M. San; Merino, Borja; González-Fajardo, J.A.; Taylor, James

doi:10.1016/j.jvs.2011.07.091

Cited by 15 publications

(19 citation statements)

References 12 publications

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“…There are two ways for foreign objects to penetrate the vascular tree (arterial or venous): by direct entry into the lumen or by the erosion of the vessel wall [ 10 ]. This embolization could be arterial or venous (80% versus 20%), and the embolism could occur at the moment of the impact or take place hours or days after the impact [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Femoral Embolization after Cardiac Gunshot

Toscano¹,

Terra

Salisbury

2018

Case Reports in Emergency Medicine

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Bullet embolism is an uncommon complication from heart gunshot injuries because most of the patients die immediately after trauma. The low frequency of this complication combined with the possible absence of symptoms makes the condition a challenge for the surgeon, delaying diagnostics and leading to severe complications or death. In this case, a small calibre bullet entered the left ventricle and then impacted the femoris artery.

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Section: Discussionmentioning

confidence: 99%

Femoral Embolization after Cardiac Gunshot

Toscano¹,

Terra

Salisbury

2018

Case Reports in Emergency Medicine

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“…The gold standard treatment for BE when there are neurological signs is surgical removal with open and endovascular options 12. In some cases, surgical embolectomy may not be possible due to vessel size, vasospasm and iatrogenic injury 13. The endovascular removal of metallic pellets is generally felt to be inappropriate, because projectiles may damage the ICA as they are withdrawn.…”

Section: Discussionmentioning

confidence: 99%

Gunshot bullet embolisation in the middle cerebral artery

Sahin

Yakar²,

Özgüral

et al. 2017

J R Army Med Corps

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“…Si-Youn Song, MD, PhD 1 , Chang Hoon Bae, MD, PhD 1 , Yong-Dae Kim, MD, PhD 1,2 , and Yoon Seok Choi, MD, PhD 1…”

Section: Intravascular Migration Of a Metallic Foreign Body After A Pmentioning

confidence: 99%

“…1 In addition, an intravascular foreign body can migrate further and reach other organs, such as the brain or heart. 2,3 Without early diagnosis and treatment, residual foreign bodies remain a major cause of mortality.…”

Section: Head and Neck Clinicmentioning

confidence: 99%

Intravascular Migration of a Metallic Foreign Body After a Penetrating Neck Injury

et al. 2019

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Head and Neck ClinicA 50-year-old man visited the emergency department of our hospital with a neck injury. The blade of a grass cutter suddenly dislodged on impact and penetrated his neck. Piercing pain and mild neck discomfort followed, but there was no massive bleeding or respiratory distress. Upon physical examination, a 7-mm-sized linear skin laceration was noted at the left upper lateral neck on the anterior border of the sternocleidomastoid (SCM) muscle. The foreign body was not visible but vaguely palpable under the skin.Soft tissue X-ray and computed tomography (CT) imaging of the neck were performed to clarify the existence of the foreign body. The neck soft tissue X-ray images revealed a radiopaque foreign body in the neck. The CT images also showed that the foreign body, a suspected fragment of a metal blade, was located on the lateral surface of the left SCM muscle and very close to the external jugular vein (Figure 1). Since the location of the foreign body was not sufficiently deep, an operation for foreign body removal was performed under local anesthesia by an on-call resident from the ear, nose, and throat department. A dissection was performed using a knife and a pair of forceps. Unexpectedly, the foreign body was not found in the position previously confirmed. The location of the foreign body was rechecked under X-ray guidance, which showed that the foreign body had migrated to a position higher than the initial position. A follow-up CT scan was then performed. Unlike the initial CT image, the foreign body was located in the left parapharyngeal space (Figure 2). To remove the foreign body safely, neck exploration under general anesthesia was planned. An approximately 5-cm-sized horizontal skin incision was made below the inferior border of the mandible in a skin crease. The dissection proceeded along the medial side of the submandibular gland to enter the parapharyngeal space. With gentle palpation, the foreign body was identified in a vessel, which appeared to be a retromandibular vein. The proximal and distal portions of the vein in which the foreign body was situated were clamped to prevent additional migration. A horizontal incision was performed using a No. 15 blade. A 7 mm Â 3 mm-sized metallic material was removed from the vascular lumen (Figure 3). The patient recovered without complications.Foreign body residue is commonly observed after penetrating neck injuries in different settings. Some small particles can

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Shotgun wound and pellet embolism to the intracranial carotid artery

Cited by 15 publications

References 12 publications

Femoral Embolization after Cardiac Gunshot

Femoral Embolization after Cardiac Gunshot

Gunshot bullet embolisation in the middle cerebral artery

Intravascular Migration of a Metallic Foreign Body After a Penetrating Neck Injury

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