Analysis of 18 recent cases of penetrating injuries to the common and internal carotid arteries.

Abstract:

:Penetrating injuries to the common and internal carotid artery carry the unique potential for irreversible neurologic damage, respiratory collapse, and exsanguination. This study analyzes a recent 4 year experience with 18 cases of penetrating injury to the carotid artery to identify the factors influencing surgical decision-making, perioperative complications, and mortality. Sixteen patients with acute respiratory distress required emergent airway intubation. Three patients in hemorrhagic shock were brought directly to the operating room; the remaining 15 underwent emergency carotid arteriography. Three patients with multiple intramediastinal vascular injuries exsanguinated on the operating table before hemorrhage could be controlled. There were no deaths or neurologic complications in the 14 surviving patients who had an operation on the carotid artery, including 2 patients treated by internal carotid artery ligation. Early control of the airway was the most common initial requirement in this group of patients. Judicious use of preoperative arteriography was thought to facilitate the operative approach in selected patients. A flexible surgical approach to the damaged carotid artery is essential based on the patient's hemodynamic status, degree of neurologic impairment, and nature and extent of arterial damage.

journal_name

Am J Surg

authors

Meyer JP,Walsh J,Barrett J,Schuler JJ,Durham JR,Eldrup-Jorgensen J,Schwarcz TH,Flanigan DP

doi

10.1016/s0002-9610(88)80363-5

subject

Has Abstract

pub_date

1988-08-01 00:00:00

pages

96-9

issue

2

eissn

0002-9610

issn

1879-1883

pii

S0002-9610(88)80363-5

journal_volume

156

pub_type

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