Combined carotid-vertebral arterial trauma
R. J. Landreneau, J. A. Weigelt, S. M. Megison, D. E. Meier and W. J. Fry
Division of Cardiothoracic Surgery, University of Missouri, Columbia.
Eight patients with simultaneous penetrating trauma to the carotid and
vertebral arteries among 129 carotid and 53 vertebral arterial injuries
have been treated in the last 14 years. In contrast to a 10% mortality with
isolated carotid or vertebral trauma, the mortality associated with this
injury complex was 50%. This high mortality directly related to the overall
complexity of the trauma sustained by these patients. The liberal use of
arteriography to assess penetrating cervical trauma has enhanced the
diagnosis of these injuries. We recommend simultaneous surgical management
of the carotid and vertebral arterial injury through an extended anterior
cervical approach.
