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Journal Article
Exploring penetrating carotid Injuries: Low grade, low yield?
2025
Overview
The role of mandatory exploration and repair of low-grade penetrating carotid injuries is unclear. We aim to compare outcomes of those managed non-operatively and operatively.
A single-center retrospective (1/2012–12/2023) review of penetrating common carotid (CCA) and internal carotid arteries (ICA) was performed. Low-grade injuries were defined as intimal dissections and intramural hematomas. Patients with low-grade injuries managed non-operatively and operatively were compared.
There were 54 patients with 62 low-grade injuries. Ten patients underwent operative management, of which 90 % had non-therapeutic vascular explorations. One patient expired due to neurologic decline and herniation. Of the 44 patients managed non-operatively, none expired due to a decline in their neurologic exam. There was no difference in stroke rates between the groups.
Stroke rates were similar between non-operatively and operatively managed low-grade penetrating CCA and ICA injuries. CT imaging should be considered in stable patients with penetrating neck trauma to characterize their vascular injury, as low-grade injuries may be managed non-operatively without significant sequelae.
•There was no difference in stroke rate between operative vs non-operative management of low-grade ICA and CCA injuries.•If low-grade injury on CT and no aerodigestive injury, management can proceed without vascular neck exploration.•Low-grade penetrating ICA and CCA injuries can be safely managed non-operatively.
Publisher
Elsevier Inc,Elsevier Limited
Subject
/ Aged
/ Carotid Artery Injuries - complications
/ Carotid Artery Injuries - diagnostic imaging
/ Carotid Artery Injuries - surgery
/ Carotid Artery Injuries - therapy
/ Carotid Artery, Internal - diagnostic imaging
/ Female
/ Hematoma
/ Humans
/ Injuries
/ Male
/ Neck
/ Patients
/ Stroke
/ Trauma
/ Wounds, Penetrating - diagnostic imaging
/ Wounds, Penetrating - surgery
