Semin intervent Radiol 2021; 38(01): 053-063
DOI: 10.1055/s-0041-1724008
Review Article

Endovascular Considerations in Traumatic Injury of the Carotid and Vertebral Arteries

Ananth K. Vellimana
1   Department of Neurological Surgery, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
,
Jayson Lavie
2   Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
,
Arindam Rano Chatterjee
1   Department of Neurological Surgery, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
› Author Affiliations

Abstract

Cervical carotid and vertebral artery traumatic injuries can have a devastating natural history. This article reviews the epidemiology, mechanisms of injury, clinical presentation, and classification systems pertinent to consideration of endovascular treatment. The growing role of modern endovascular techniques for the treatment of these diseases is presented to equip endovascular surgeons with a framework for critically assessing patients presenting with traumatic cervical cerebrovascular injury.



Publication History

Article published online:
15 April 2021

© 2021. Thieme. All rights reserved.

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  • References

  • 1 Fabian TC, Patton Jr JH, Croce MA, Minard G, Kudsk KA, Pritchard FE. Blunt carotid injury. Importance of early diagnosis and anticoagulant therapy. Ann Surg 1996; 223 (05) 513-522 , discussion 522–525
  • 2 Harrigan MR, Hadley MN, Dhall SS. et al. Management of vertebral artery injuries following non-penetrating cervical trauma. Neurosurgery 2013; 72 (Suppl. 02) 234-243
  • 3 Cogbill TH, Moore EE, Meissner M. et al. The spectrum of blunt injury to the carotid artery: a multicenter perspective. J Trauma 1994; 37 (03) 473-479
  • 4 White JM, Stannard A, Burkhardt GE, Eastridge BJ, Blackbourne LH, Rasmussen TE. The epidemiology of vascular injury in the wars in Iraq and Afghanistan. Ann Surg 2011; 253 (06) 1184-1189
  • 5 Esnault P, Cardinale M, Boret H. et al. Blunt cerebrovascular injuries in severe traumatic brain injury: incidence, risk factors, and evolution. J Neurosurg 2017; 127 (01) 16-22
  • 6 Biffl WL, Moore EE, Offner PJ, Brega KE, Franciose RJ, Burch JM. Blunt carotid arterial injuries: implications of a new grading scale. J Trauma 1999; 47 (05) 845-853
  • 7 Berne JD, Norwood SH, McAuley CE, Vallina VL, Creath RG, McLarty J. The high morbidity of blunt cerebrovascular injury in an unscreened population: more evidence of the need for mandatory screening protocols. J Am Coll Surg 2001; 192 (03) 314-321
  • 8 Miller PR, Fabian TC, Croce MA. et al. Prospective screening for blunt cerebrovascular injuries: analysis of diagnostic modalities and outcomes. Ann Surg 2002; 236 (03) 386-393 , discussion 393–395
  • 9 Kerwin AJ, Bynoe RP, Murray J. et al. Liberalized screening for blunt carotid and vertebral artery injuries is justified. J Trauma 2001; 51 (02) 308-314
  • 10 Berne JD, Norwood SH, McAuley CE, Villareal DH. Helical computed tomographic angiography: an excellent screening test for blunt cerebrovascular injury. J Trauma 2004; 57 (01) 11-17 , discussion 17–19
  • 11 Asensio JA, Vu T, Mazzini FN. et al. Penetrating carotid artery: uncommon complex and lethal injuries. Eur J Trauma Emerg Surg 2011; 37 (05) 429
  • 12 Tisherman SA, Bokhari F, Collier B. et al. Clinical practice guideline: penetrating zone II neck trauma. J Trauma 2008; 64 (05) 1392-1405
  • 13 Lee VH, Brown Jr RD, Mandrekar JN, Mokri B. Incidence and outcome of cervical artery dissection: a population-based study. Neurology 2006; 67 (10) 1809-1812
  • 14 Béjot Y, Daubail B, Debette S, Durier J, Giroud M. Incidence and outcome of cerebrovascular events related to cervical artery dissection: the Dijon Stroke Registry. Int J Stroke 2014; 9 (07) 879-882
  • 15 Touzé E, Gauvrit J, Meder J, Mas J. Prognosis of cervical artery dissection. Front Neurol Neurosci 2005; 20: 129-139
  • 16 Landreneau RJ, Weigelt JA, Megison SM, Meier DE, Fry WJ. Combined carotid-vertebral arterial trauma. Arch Surg 1992; 127 (03) 301-304
  • 17 Herrera FA, Mareno JA, Easter D. Management of penetrating neck injuries: zone II. J Surg Educ 2007; 64 (02) 75-78
  • 18 Bladergroen M, Brockman R, Luna G, Kohler T, Johansen K. A twelve-year survey of cervicothoracic vascular injuries. Am J Surg 1989; 157 (05) 483-486
  • 19 Roon AJ, Christensen N. Evaluation and treatment of penetrating cervical injuries. J Trauma 1979; 19 (06) 391-397
  • 20 Albuquerque FC, Hu YC, Dashti SR. et al. Craniocervical arterial dissections as sequelae of chiropractic manipulation: patterns of injury and management. J Neurosurg 2011; 115 (06) 1197-1205
  • 21 Groves AP, Kansagra AP, Cross III DT, Moran CJ, Derdeyn CP. Acute management and outcomes of iatrogenic dissections during cerebral angiography. J Neurointerv Surg 2017; 9 (05) 499-501
  • 22 Chang FC, Lirng JF, Luo CB. et al. Patients with head and neck cancers and associated postirradiated carotid blowout syndrome: endovascular therapeutic methods and outcomes. J Vasc Surg 2008; 47 (05) 936-945
  • 23 Yang ST, Huang YC, Chuang CC, Hsu PW. Traumatic internal carotid artery dissection. J Clin Neurosci 2006; 13 (01) 123-128
  • 24 Azuaje RE, Jacobson LE, Glover J. et al. Reliability of physical examination as a predictor of vascular injury after penetrating neck trauma. Am Surg 2003; 69 (09) 804-807
  • 25 Scheid R, Zimmer C, Schroeter ML, Ballaschke O, von Cramon DY. The clinical spectrum of blunt cerebrovascular injury. Neurologist 2006; 12 (05) 255-262
  • 26 Ledgerwood AM, Mullins RJ, Lucas CE. Primary repair vs ligation for carotid artery injuries. Arch Surg 1980; 115 (04) 488-493
  • 27 Uyeda JW, Anderson SW, Sakai O, Soto JA. CT angiography in trauma. Radiol Clin North Am 2010; 48 (02) 423-438 , ix–x
  • 28 Bodanapally UK, Dreizin D, Sliker CW, Boscak AR, Reddy RP. Vascular injuries to the neck after penetrating trauma: diagnostic performance of 40- and 64-MDCT angiography. AJR Am J Roentgenol 2015; 205 (04) 866-872
  • 29 Schroeder JW, Baskaran V, Aygun N. Imaging of traumatic arterial injuries in the neck with an emphasis on CTA. Emerg Radiol 2010; 17 (02) 109-122
  • 30 Inaba K, Branco BC, Menaker J. et al. Evaluation of multidetector computed tomography for penetrating neck injury: a prospective multicenter study. J Trauma Acute Care Surg 2012; 72 (03) 576-583 , discussion 583–584, quiz 803–804
  • 31 Shahan CP, Magnotti LJ, Stickley SM. et al. A safe and effective management strategy for blunt cerebrovascular injury: avoiding unnecessary anticoagulation and eliminating stroke. J Trauma Acute Care Surg 2016; 80 (06) 915-922
  • 32 Bromberg WJ, Collier BC, Diebel LN. et al. Blunt cerebrovascular injury practice management guidelines: the Eastern Association for the Surgery of Trauma. J Trauma 2010; 68 (02) 471-477
  • 33 Kaufmann TJ, Huston III J, Mandrekar JN, Schleck CD, Thielen KR, Kallmes DF. Complications of diagnostic cerebral angiography: evaluation of 19,826 consecutive patients. Radiology 2007; 243 (03) 812-819
  • 34 Múnera F, Cohn S, Rivas LA. Penetrating injuries of the neck: use of helical computed tomographic angiography. J Trauma 2005; 58 (02) 413-418
  • 35 Múnera F, Soto JA, Palacio D, Velez SM, Medina E. Diagnosis of arterial injuries caused by penetrating trauma to the neck: comparison of helical CT angiography and conventional angiography. Radiology 2000; 216 (02) 356-362
  • 36 Demetriades D, Skalkides J, Sofianos C, Melissas J, Franklin J. Carotid artery injuries: experience with 124 cases. J Trauma 1989; 29 (01) 91-94
  • 37 Fusco MR, Harrigan MR. Cerebrovascular dissections--a review part I: spontaneous dissections. Neurosurgery 2011; 68 (01) 242-257 , discussion 257
  • 38 Fusco MR, Harrigan MR. Cerebrovascular dissections: a review. Part II: Blunt cerebrovascular injury. Neurosurgery 2011; 68 (02) 517-530 , discussion 530
  • 39 Moon TH, Kim SH, Lee JW, Huh SK. Clinical analysis of traumatic cerebral pseudoaneurysms. Korean J Neurotrauma 2015; 11 (02) 124-130
  • 40 Yamada R, Miller C, Guimaraes M, Schönholz C. Overview of endovascular management of traumatic carotid lesions Determining appropriate intervention based on lesion severity and patient characteristics. Endov Today 2016; 15 (01) 79-82
  • 41 Blitzer DN, Ottochian M, O'Connor JV. et al. Timing of intervention may influence outcomes in blunt injury to the carotid artery. J Vasc Surg 2020; 71 (04) 1323-1332.e5 , e1325
  • 42 Starnes BW, Arthurs ZM. Endovascular management of vascular trauma. Perspect Vasc Surg Endovasc Ther 2006; 18 (02) 114-129
  • 43 Ditmars ML, Klein SR, Bongard FS. Diagnosis and management of zone III carotid injuries. Injury 1997; 28 (08) 515-520
  • 44 Scott WW, Sharp S, Figueroa SA. et al. Clinical and radiographic outcomes following traumatic Grade 1 and 2 carotid artery injuries: a 10-year retrospective analysis from a Level I trauma center. The Parkland Carotid and Vertebral Artery Injury Survey. J Neurosurg 2015; 122 (05) 1196-1201
  • 45 Biffl WL, Ray Jr CE, Moore EE. et al. Treatment-related outcomes from blunt cerebrovascular injuries: importance of routine follow-up arteriography. Ann Surg 2002; 235 (05) 699-706 , discussion 706–707
  • 46 Wahl WL, Brandt MM, Thompson BG, Taheri PA, Greenfield LJ. Antiplatelet therapy: an alternative to heparin for blunt carotid injury. J Trauma 2002; 52 (05) 896-901
  • 47 Cothren CC, Biffl WL, Moore EE, Kashuk JL, Johnson JL. Treatment for blunt cerebrovascular injuries: equivalence of anticoagulation and antiplatelet agents. Arch Surg 2009; 144 (07) 685-690
  • 48 DuBose J, Recinos G, Teixeira PG, Inaba K, Demetriades D. Endovascular stenting for the treatment of traumatic internal carotid injuries: expanding experience. J Trauma 2008; 65 (06) 1561-1566
  • 49 Lee TS, Ducic Y, Gordin E, Stroman D. Management of carotid artery trauma. Craniomaxillofac Trauma Reconstr 2014; 7 (03) 175-189
  • 50 Cothren CC, Moore EE, Ray Jr CE. et al. Carotid artery stents for blunt cerebrovascular injury: risks exceed benefits. Arch Surg 2005; 140 (05) 480-485 , discussion 485–486
  • 51 Markus HS, Hayter E, Levi C, Feldman A, Venables G, Norris J. CADISS Trial Investigators. Antiplatelet treatment compared with anticoagulation treatment for cervical artery dissection (CADISS): a randomised trial. Lancet Neurol 2015; 14 (04) 361-367
  • 52 Duke BJ, Ryu RK, Coldwell DM, Brega KE. Treatment of blunt injury to the carotid artery by using endovascular stents: an early experience. J Neurosurg 1997; 87 (06) 825-829
  • 53 Pham MH, Rahme RJ, Arnaout O. et al. Endovascular stenting of extracranial carotid and vertebral artery dissections: a systematic review of the literature. Neurosurgery 2011; 68 (04) 856-866 , discussion 866
  • 54 Xianjun H, Zhiming Z. A systematic review of endovascular management of internal carotid artery dissections. Intervent Neurol 2013; 1 (3-4): 164-170
  • 55 Kansagra AP, Cooke DL, English JD. et al. Current trends in endovascular management of traumatic cerebrovascular injury. J Neurointerv Surg 2014; 6 (01) 47-50
  • 56 Brzezicki G, Rivet DJ, Reavey-Cantwell J. Pipeline embolization device for treatment of high cervical and skull base carotid artery dissections: clinical case series. J Neurointerv Surg 2016; 8 (07) 722-728
  • 57 Fischer S, Perez MA, Kurre W, Albes G, Bäzner H, Henkes H. Pipeline embolization device for the treatment of intra- and extracranial fusiform and dissecting aneurysms: initial experience and long-term follow-up. Neurosurgery 2014; 75 (04) 364-374 , discussion 374
  • 58 Zeleňák K, Zeleňáková J, DeRiggo J, Kurča E, Kantorová E, Poláček H. Treatment of cervical internal carotid artery spontaneous dissection with pseudoaneurysm and unilateral lower cranial nerves palsy by two silk flow diverters. Cardiovasc Intervent Radiol 2013; 36 (04) 1147-1150
  • 59 Ahn JY, Chung YS, Lee BH, Choi SW, Kim OJ. Stent-graft placement in a traumatic internal carotid-internal jugular fistula and pseudoaneurysm. J Clin Neurosci 2004; 11 (06) 636-639
  • 60 Kooraki S, Grohmann J, Elshikh S, Urbach H, Meckel S. Covered stents for exclusion of iatrogenic common carotid artery-internal jugular vein fistula and brachiocephalic artery pseudoaneurysm. J Neurointerv Surg 2016; 8 (08) e31
  • 61 Maras D, Lioupis C, Magoufis G, Tsamopoulos N, Moulakakis K, Andrikopoulos V. Covered stent-graft treatment of traumatic internal carotid artery pseudoaneurysms: a review. Cardiovasc Intervent Radiol 2006; 29 (06) 958-968
  • 62 Schönholz C, Krajcer Z, Carlos Parodi J. et al. Stent-graft treatment of pseudoaneurysms and arteriovenous fistulae in the carotid artery. Vascular 2006; 14 (03) 123-129
  • 63 Schönholz CJ, Uflacker R, De Gregorio MA, Parodi JC. Stent-graft treatment of trauma to the supra-aortic arteries. A review. J Cardiovasc Surg (Torino) 2007; 48 (05) 537-549
  • 64 Manzoor NF, Rezaee RP, Ray A. et al. Contemporary management of carotid blowout syndrome utilizing endovascular techniques. Laryngoscope 2017; 127 (02) 383-390
  • 65 Radvany MG, Gailloud P. Endovascular management of neurovascular arterial injuries in the face and neck. Semin Intervent Radiol 2010; 27 (01) 44-54
  • 66 Eckard DA, Purdy PD, Bonte FJ. Temporary balloon occlusion of the carotid artery combined with brain blood flow imaging as a test to predict tolerance prior to permanent carotid sacrifice. AJNR Am J Neuroradiol 1992; 13 (06) 1565-1569
  • 67 Mazumdar A, Derdeyn CP, Holloway W, Moran CJ, Cross III DT. Update on endovascular management of the carotid blowout syndrome. Neuroimaging Clin N Am 2009; 19 (02) 271-281
  • 68 Kremer C, Mosso M, Georgiadis D. et al. Carotid dissection with permanent and transient occlusion or severe stenosis: long-term outcome. Neurology 2003; 60 (02) 271-275
  • 69 Cohen JE, Gomori JM, Itshayek E. et al. Single-center experience on endovascular reconstruction of traumatic internal carotid artery dissections. J Trauma Acute Care Surg 2012; 72 (01) 216-221
  • 70 Kortbeek JB, Al Turki SA, Ali J. et al. Advanced trauma life support, 8th edition, the evidence for change. J Trauma 2008; 64 (06) 1638-1650
  • 71 Klein GE, Szolar DH, Raith J, Frühwirth H, Pascher O, Hausegger KA. Posttraumatic extracranial aneurysm of the internal carotid artery: combined endovascular treatment with coils and stents. AJNR Am J Neuroradiol 1997; 18 (07) 1261-1264
  • 72 Lesley WS. Endosurgical repair of an iatrogenic facial arteriovenous fistula due to percutaneous trigeminal balloon rhizotomy. J Neurosurg Sci 2007; 51 (04) 177-180
  • 73 Gaba RC, West DL, Bui JT, Owens CA, Marden FA. Covered stent treatment of carotid blowout syndrome. Semin Intervent Radiol 2007; 24 (01) 47-52
  • 74 Shah H, Gemmete JJ, Chaudhary N, Pandey AS, Ansari SA. Acute life-threatening hemorrhage in patients with head and neck cancer presenting with carotid blowout syndrome: follow-up results after initial hemostasis with covered-stent placement. AJNR Am J Neuroradiol 2011; 32 (04) 743-747
  • 75 Aljobeh A, Sorenson TJ, Bortolotti C, Cloft H, Lanzino G. Vertebral arteriovenous fistula: a review article. World Neurosurg 2019; 122: e1388-e1397
  • 76 Herrera DA, Vargas SA, Dublin AB. Endovascular treatment of traumatic injuries of the vertebral artery. AJNR Am J Neuroradiol 2008; 29 (08) 1585-1589
  • 77 Higashida RT, Halbach VV, Tsai FY. et al. Interventional neurovascular treatment of traumatic carotid and vertebral artery lesions: results in 234 cases. AJR Am J Roentgenol 1989; 153 (03) 577-582
  • 78 Miller RE, Hieshima GB, Giannotta SL, Grinnell VS, Mehringer CM, Kerin DS. Acute traumatic vertebral arteriovenous fistula: balloon occlusion with the use of a contralateral approach. Neurosurgery 1984; 14 (02) 225-229
  • 79 Santos-Franco JA, Zenteno M, Lee A. Dissecting aneurysms of the vertebrobasilar system. A comprehensive review on natural history and treatment options. Neurosurg Rev 2008; 31 (02) 131-140 , discussion 140
  • 80 Yi AC, Palmer E, Luh GY, Jacobson JP, Smith DC. Endovascular treatment of carotid and vertebral pseudoaneurysms with covered stents. AJNR Am J Neuroradiol 2008; 29 (05) 983-987
  • 81 Delgado F, Bravo I, Jiménez E. et al. Endovascular treatment in the acute and non-acute phases of carotid dissection: a therapeutic approach. J Neurointerv Surg 2017; 9 (01) 11-16
  • 82 Marnat G, Mourand I, Eker O. et al. Endovascular management of tandem occlusion stroke related to internal carotid artery dissection using a distal to proximal approach: insight from the RECOST study. AJNR Am J Neuroradiol 2016; 37 (07) 1281-1288
  • 83 Müller-Schunk S, Linn J, Peters N. et al. Monitoring of clopidogrel-related platelet inhibition: correlation of nonresponse with clinical outcome in supra-aortic stenting. AJNR Am J Neuroradiol 2008; 29 (04) 786-791