Aspirin Alone Is Superior Therapy for Grade III Blunt Carotid Injury: A Multicenter Study from the Eastern Association for the Surgery of Trauma

Abstract

The optimal treatment of blunt cerebrovascular injury (BCVI) remains unclear. Antiplatelet therapy and therapeutic anticoagulation have each demonstrated substantial reductions in BCVI-associated stroke without evidence of the superiority of either. Uncertainty surrounds grade III injury, in particular, because stroke can involve both platelet activation from endothelial injury and thrombus formation within the pseudoaneurysm sac. We hypothesized that treatment of grade III blunt carotid injury (BCI) with aspirin alone would be associated with a decreased rate of subsequent stroke compared with other medical therapies.