The following is a summary of “Exploring the Role of endovascular interventions in blunt carotid and vertebral artery trauma,” published in the November 2023 issue of Surgery by Biffl, et al.
The role of endovascular interventions (EI) in the management of blunt carotid and vertebral artery injuries (BCI and BVI) remains uncertain.
For a study, researchers sought to evaluate the efficacy of EI compared with antithrombotic therapy (AT) in treating these injuries, providing valuable insights for future prospective investigations.
A retrospective review covering the period from 2017 to 2022 was conducted on records at a Level I trauma center to gather information on injury characteristics, treatment modalities, and outcomes. The primary outcome of interest was the occurrence of stroke.
Ninety-six patients experienced 106 injuries, comprising 74 BVI and 32 BCI cases. Among these, 12 patients underwent 13 endovascular interventions, 4 being therapeutic and 9 prophylactic. Stroke events were observed in 12 patients; of these, 6 had undergone endovascular interventions. In cases of grade IV BVI, both EI and AT demonstrated low stroke rates. Notably, thrombectomy following a stroke improved neurologic function in all 4 patients (100%).
The majority of strokes occurred before the initiation of preventive therapy, and neither antithrombotic therapy nor endovascular interventions achieved 100% efficacy in preventing strokes. However, thrombectomy showed promise in enhancing neurologic outcomes after a stroke. The findings underscored the need for a prospective multicenter study to provide more comprehensive insights into the optimal management of blunt carotid and vertebral artery injuries.
Source: americanjournalofsurgery.com/article/S0002-9610(23)00361-6/fulltext