Carotid Artery Injuries ; therapy ; Carotid-Cavernous Sinus Fistula ; therapy ; Embolization, Therapeutic ; methods ; Humans ; Male ; Middle Aged ; Stents

Extracranial carotid artery dissection may manifest as arterial stenosis or occlusion, or as dissecting aneurysm formation. Anticoagulation and/or antiplatelet therapy is the first-line treatment, but because it is effective and less invasive than other procedures, endovascular treatment of carotid artery dissection has recently attracted interest. We encountered two consecutive cases of traumarelated extracranial internal carotid artery dissection, one in the suprabulbar portion and one in the subpetrosal portion. We managed the patient with suprabulbar dissection using a self-expandable metallic stent and managed the patient with subpet-rosal dissection using a balloon-expandable metallic stent. In both patients the dissecting aneurysm disappeared, and at follow-up improved luminal patency was observed.
Adult ; Carotid Artery Injuries/complications ; Carotid Artery, Internal, Dissection/etiology/radiography/*therapy ; Case Report ; Cerebral Angiography ; Human ; Male ; *Stents

Carotid artery dissection is a significant cause of stroke in young patients. It may be asymptomatic and go undiagnosed, or minimal transient manifestations may follow, commanding a higher index of suspicion than ordinarily exists to avoid misdiagnosis. Reported herein is a 27-year-old man who suffered extracranial internal carotid artery dissection while practicing a Brazilian Jiu-Jitsu submission maneuver. The patient's condition suddenly deteriorated one week later due to distal embolization and stroke. Despite endovascular treatment, with stenting of the cervical carotid artery, neurologic deficits remained. Of note, the objective in martial arts, which is to kill or incapacitate, has yet to be fully tempered in transitioning to sport. Brazilian Jiu-jitsu, a relatively new and fast-growing form of martial art, places emphasis on submission maneuvers. Related injuries are not common knowledge and are poorly described in the literature. This account is intended to shed light on the risk of this discipline. Through education and improved supervision, vascular injuries of this nature and the potentially lethal or disabling consequences may thus be prevented in young athletes.
Adult ; Athletes ; Carotid Arteries ; Carotid Artery Injuries ; Carotid Artery, Internal* ; Carotid Artery, Internal, Dissection* ; Diagnostic Errors ; Education ; Humans ; Martial Arts ; Neurologic Manifestations ; Organization and Administration ; Sports ; Stents ; Stroke ; Vascular System Injuries

The incidence of spontaneous recanalization after traumatic internal carotid artery occlusion is very rare. We have experienced a case of spontaneous recanalization after a traumatic internal carotid artery occlusion. A 5-year-old boy developed contra-lateral hemiparesis and dysphasia after a blunt injury on the head and neck. He had a complete left internal carotid artery occlusion which was diagnosed through angiography. We treated the patient with an antiplatelet agent and rehabilitation. Six months later, he regained motor power of right extremities, language ability, and revisualization of internal carotid artery on the follow-up magnetic angiography. We confirmed a recanalization of injured internal carotid artery on the conventional cerebral angiography which was performed one year later. We suggest conservative treatment with serial angiographic studies as a possible option of traumatic internal carotid artery occlusion even though there is hemodynamic instability.
Angiography ; Aphasia ; Carotid Artery Injuries ; Carotid Artery, Internal* ; Carotid Artery, Internal, Dissection ; Cerebral Angiography ; Child, Preschool ; Extremities ; Follow-Up Studies ; Head ; Hemodynamics ; Humans ; Incidence ; Language ; Male ; Neck ; Paresis ; Rehabilitation ; Wounds, Nonpenetrating

No abstract available.
Aneurysm, False ; Carotid Artery Injuries*

Surgical resection is the only option for the treatment of carotid body tumor. The tumor is characterized by its hypervascularity and adherence to the carotid artery. Neurovascular injuries have been a well known surgical complication during the procedure. We experienced a case of carotid artery injury during the resection of carotid body tumor and which was reconstructed with interposition graft using autogenous vein. Vascular injury as a complication during the resection of carotid body tumor was reviewed.
Carotid Arteries ; Carotid Artery Injuries ; Carotid Body Tumor ; Carotid Body ; Transplants ; Vascular System Injuries ; Veins

OBJECTIVETo discuss the diagnosis and management of traumatic carotid cavernous fistula (TCCF).

METHODSIn all 15 patients with TCCF confirmed by angiography, 8 patients got early diagnosis and cure. With Seldinger technique adopted in the puncture of femoral artery, Magic 3 F-1.8 F BD catheters combining with balloon were used to embolize the fistula or the internal carotid artery.

RESULTSEarly diagnosis and cure were achieved in 8 patients within one week and no sequelae occurred. Seven patients with delayed diagnosis who were cured beyond one week had some sequelae such as hypopsia in 5 cases, incomplete oculomotor paralyses in 3 and incomplete abducent paralyses in 2. Among all the 15 cases, the internal carotid artery was preserved in 12 cases accounting for 80%. Occluding the fistula with sacrifice of the internal carotid artery was performed in 3 cases and no repatency of the fistula occurred by following up beyond three months.

CONCLUSIONSThe preferred therapy for TCCF is to occlude the fistula using detachable balloon. The diagnosis and treatment for TCCF can significantly reduce occurrence rate of the complications and sequelae.

Accidents, Traffic ; Adolescent ; Adult ; Arteriovenous Fistula ; diagnostic imaging ; therapy ; Carotid Artery Injuries ; diagnostic imaging ; therapy ; Cavernous Sinus ; injuries ; Cerebral Angiography ; methods ; Embolization, Therapeutic ; methods ; Female ; Follow-Up Studies ; Humans ; Injury Severity Score ; Male ; Middle Aged ; Prospective Studies ; Risk Assessment ; Treatment Outcome

There are many vital structures in the neck, but they are not protected by bone. The neck is vulnerable to injury, and difficult to evaluate the extent of injury. Especially, penetrating neck wounds are potentially dangerous and require emergency treatment. A 56-year-old man with a penetrating neck injury by a grass cutter fragment was transferred from another hospital. There were no immediate life-threatening signs or symptoms. Carotid artery injury was suspected in the computed tomography scan. Emergent exploration was implemented by vascular surgery to remove the grass cutter fragment that had penetrated the left common carotid artery. We report a rare case of common carotid artery penetrating injury that was treated without any complications.
Carotid Artery Injuries ; Carotid Artery, Common ; Emergency Treatment ; Humans ; Middle Aged ; Neck ; Neck Injuries ; Poaceae ; Pregnancy

Penetrating neck injuries are potentially dangerous and require emergent management because of vital structures in the neck. A 35-year-old woman was transferred to the hospital with massive bleeding in her mouth and lacerations of her neck after the stab injuries. Contrast-enhanced computed tomography (CT) and angiography revealed a leakage at the pharyngeal portion of the right internal carotid artery. Emergent endovascular treatment was undertaken by using the stent technique. The leakage was completely occluded immediately after the procedure. There was no complication. The stent technique was safe and effective for the treatment of zone III carotid artery stab injuries.
Adult ; Angiography ; Carotid Arteries ; Carotid Artery Injuries ; Carotid Artery, Internal ; Female ; Hemorrhage ; Humans ; Lacerations ; Mouth ; Neck ; Neck Injuries ; Stents

BACKGROUND AND OBJECTIVES: ovastatin, a HMG-CoA reductase inhibitor, is known to show antiproliferative effects on VSMC after vessel injury, but a large amount of the drug is needed orally for this purpose. This study investigated the effects of lovastatin given locally to injured carotid arteries of rats on reducing neointimal hyperplasia. MATERIALS AND METHOD: Lovastatin was given perivascularly to balloon-injured carotid arteries of 21 rats in 1 microM to the low-dose group, and 30 microM to the high-dose group. The control group was treated with pluronic gel only. Two weeks later, the lumen area, neointimal areas and the number of actively proliferating cells were obtained and compared. RESULTS: eointimal area was 0.113+/-0.032 mm2, 0.065+/-0.017 mm2, 0.072+/-0.017 mm2 in the control, low-dose and high-dose groups respectively. The area was significantly smaller in the treatment groups (p<0.05), but no significant difference was observed between the treatment groups. The number of actively proliferating cells per mm2 of neointimal area were 714.5+/-227.4, 688.4+/-333.7, and 1526.3+/-744.0 in the groups respectively, and the number was significantly high in the high-dose group (p<0.05). CONCLUSION: Local administration of lovastatin is effective in reducing neointimal hyperplasia after vascular injury, but extremely high doses are not needed locally for this purpose.
Animals ; Carotid Arteries* ; Carotid Artery Injuries* ; Hyperplasia* ; Lovastatin* ; Oxidoreductases ; Rats* ; Vascular System Injuries