Vascular Trauma in the Head and Neck and Endovascular Neurointerventional Management

Patel, Jeet; Huynh, Thien; Rao, Dinesh; Brzezicki, Grzegorz

doi:10.25259/jcis_96_2020

Cited by 10 publications

(6 citation statements)

References 20 publications

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“…The management of traumatic vascular injuries in the head and neck region represents a significant challenge in trauma care due to the complex anatomy of the region and the essential functions of the vessels involved. These injuries carry the risk of serious complications such as excessive bleeding, potential stroke, and the possibility of death [1,4]. Our experience in treating 21 patients over a decade underscores the efficacy of endovascular treatment in managing various traumatic vascular injuries in this area.…”

Section: Discussionmentioning

confidence: 94%

“…This progress is particularly promising for patients with complex vascular traumas, who might have previously been considered unsuitable or at high risk for conventional surgery. These advances in endovascular therapy are redefining treatment options and improving care possibilities for those affected by these challenging injuries [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

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Endovascular Treatment of Traumatic Vascular Injuries in the Head and Neck Region

Koh,

Choi,

Shin

et al. 2024

Medicina

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Background and Objectives: Traumatic vascular injuries of the head and neck pose significant treatment challenges due to the complex anatomy, diverse clinical presentation, and mostly emergent nature. Endovascular treatment increasingly complements traditional surgical approaches. This study aimed to report our 10-year experience in treating traumatic vascular injuries of the head and neck with endovascular therapy and to determine the effectiveness of endovascular treatment. Materials and Methods: A retrospective analysis of 21 patients treated for head and neck vascular injuries between May 2011 and April 2021 was performed. Patients’ medical histories, clinical presentations, imaging findings, treatment materials, and clinical outcomes were reviewed. Treatments included stenting, coil embolization, and other endovascular techniques focused on hemostasis and preservation of the parent vessel. Results: The most common injuries involved the internal maxillary artery branches (n = 11), followed by the common or internal carotid artery (n = 6), vertebral artery (n = 3), and others. Endovascular treatment achieved successful hemostasis in all but one case. In five of six carotid artery injuries and two of three vertebral artery injuries, we achieved successful hemostasis while preserving the parent vessel using covered and bare stents, respectively. Conclusions: Endovascular therapy might be a useful treatment modality for traumatic vascular injuries in the head and neck region, offering efficacy, safety, and a minimally invasive approach.

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Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Endovascular Treatment of Traumatic Vascular Injuries in the Head and Neck Region

Koh,

Choi,

Shin

et al. 2024

Medicina

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“… 21 Moreover, endovascular techniques could also be applied in vascular complications, such as arteriovenous fistula and traumatic intracranial aneurysms. 22 , 23 , 24 …”

Section: Discussionmentioning

confidence: 99%

Trans-base and trans-vault low-velocity penetrating brain injury: A retrospective comparative study of characteristics, treatment, and outcomes

Chen

et al. 2021

Chinese Journal of Traumatology

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Purpose Low-velocity penetrating brain injury (LVPBI) caused by foreign bodies can pose life-threatening emergencies. Their complexity and lack of validated classification data have prevented standardization of clinical management. We aimed to compare the trans-base and trans-vault phenotypes of LVPBI to help provide guidance for clinical decision-making of such injury type. Methods A retrospective study on LVPBI patients managed at our institution from November 2013 to March 2020 was conducted. We included LVPBI patients admitted for the first time for surgery, and excluded those with multiple injuries, gunshot wounds, pregnancy, severe blunt head trauma, etc. Patients were categorized into trans-base and trans-vault LVPBI groups based on the penetration pathway. Discharged patients were followed up by outpatient visit or telephone. The data were entered into the Electronic Medical Record system by clinicians, and subsequently derived by researchers. The demography and injury characteristics, treatment protocols, complications, and outcomes were analyzed and compared between the two groups. A t -test was used for analysis of normally distributed data, and a Mann-Whitney U test for non-parametric data. A generalized linear model was further established to determine whether the factors length of stay and performance scale score were influenced by each factor. Results A total of 27 LVPBI patients were included in this analysis, comprised of 13 (48.1%) trans-base cases and 14 (51.9%) trans-vault cases. Statistical analyses suggested that trans-base LVPBI was correlated with deeper wounds; while the trans-vault phenotype was correlated with injury by metal foreign bodies. There was no difference in Glasgow Coma Scale score and the risk of intracranial hemorrhage between the two groups. Surgical approaches in the trans-base LVPBI group included subfrontal ( n = 5, 38.5%), subtemporal ( n = 5, 38.5%), lateral fissure ( n = 2, 15.4%), and distal lateral ( n = 1, 7.7%). All patients in the trans-vault group underwent a brain convex approach using the foreign body as reference ( n = 14, 100%). Moreover, the two groups differed in application prerequisites for intracranial pressure monitoring and vessel-related treatment. Trans-base LVPBI was associated with higher rates of cranial nerve and major vessel injuries; in contrast, trans-vault LVPBI was associated with lower functional outcome scores. Conclusion Our findings suggest that trans-base and trans-vault LVPBIs differ in terms of characteristics, treatment, and outcomes. Further understanding of these differences may help guide clinical decisions and contribute to a better management of LVPBIs.

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“…Пацієнти, які перенесли краніоцервікальну травму, мають ризик отримати тяжкі травми, зокрема травматичне цереброваскулярне ушкодження та черепномозкову травму [1,2]. Травматичне цереброваскулярне ушкодження виникає у 3-20 % пацієнтів після краніоцервікальної травми та є частою причиною захворюваності та смертності [1,[3][4][5]. Своєчасна діагностика і лікування можуть запобіг-ти розвитку незворотних неврологічних ускладнень [5].…”

Section: вступunclassified

Neurointerventional management of cerebrovascular trauma

Lauzier

Chatterjee²,

Kansagra

2022

Ukr. ìnterv. nejroradìol. hìr.

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Traumatic cerebrovascular injuries following blunt or penetrating trauma are common and carry a high risk of permanent disability or death. Proper screening, diagnosis, and treatment of these lesions is essential to improve patient outcomes. Advances in imaging continue to improve the accuracy of non-invasive diagnosis of these injuries while new clinical data provide better evidence for optimal management, whether medical or invasive. Here, we review screening, diagnosis, and treatment of traumatic cerebrovascular injuries.

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Vascular Trauma in the Head and Neck and Endovascular Neurointerventional Management

Cited by 10 publications

References 20 publications

Endovascular Treatment of Traumatic Vascular Injuries in the Head and Neck Region

Endovascular Treatment of Traumatic Vascular Injuries in the Head and Neck Region

Trans-base and trans-vault low-velocity penetrating brain injury: A retrospective comparative study of characteristics, treatment, and outcomes

Neurointerventional management of cerebrovascular trauma

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