Transcarotid artery revascularization in blunt carotid injury

Patrick F Walker; Grahya C Guntur; Priti Lalchandani; Jonathan J Morrison; Rishi Kundi

doi:10.1016/j.jvscit.2022.10.021

Transcarotid artery revascularization in blunt carotid injury

J Vasc Surg Cases Innov Tech. 2022 Dec 5;9(2):101073. doi: 10.1016/j.jvscit.2022.10.021. eCollection 2023 Jun.

Authors

Patrick F Walker¹, Grahya C Guntur¹, Priti Lalchandani¹, Jonathan J Morrison², Rishi Kundi¹

Affiliations

¹ R. Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, MD.
² Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN.

Abstract

Introduction: Transcarotid artery revascularization (TCAR) with flow reversal has substantially changed the management of carotid artery stenosis, enabling an endovascular approach with a periprocedural stroke rate as low as or lower than that of open carotid surgery. The use of TCAR for blunt carotid artery injury has not yet been described.

Methods: A review of the use of TCAR for blunt carotid artery injury was performed at a single center from October 2020 to August 2021. The patient demographics, mechanism of injury, and outcomes were collected and compared.

Results: Ten carotid stents were placed via TCAR in eight patients for hemodynamically significant blunt carotid artery injuries. No periprocedural neurologic events occurred, and all stents remained patent during short-term follow-up.

Conclusions: TCAR is feasible and safe in the management of significant blunt carotid artery injuries. More data are needed regarding the long-term outcomes and ideal surveillance intervals.

Keywords: Blunt cerebrovascular injury; Transcarotid artery revascularization.