Abstract
Neck trauma is the leading cause of death mainly in younger persons posing to surgeons the dilemma whether to proceed with reconstruction of vascular injuries either in the presence of coma or in severe neurological deficit. Vascular injuries in zone II predominate over the other injuries located in zones I/III of the neck. Conventional open repair of carotid injuries with primary closure or interposition grafting is always recommended due to the effective long-term results for penetrating injuries or for patients unfit for endovascular intervention. In cases of blunt trauma, anticoagulation or antiplatelet therapy should be administered first in neurologically stable patients. In case of worsening of the neurological status of the patient despite adequate anticoagulation endovascular means should be considered in cases of appropriate anatomy of the arterial trauma. We provide an update on penetrating/blunt trauma in zone II of the neck, giving emphasis on the anticoagulant and endovascular treatment.
Highlights
Frontiers in SurgeryReceived: 31 March 2017 Accepted: 08 September 2017 Published: 29 September 2017. Citation: Karaolanis G, Maltezos K, Bakoyiannis C and Georgopoulos S (2017) Contemporary Strategies in the Management of Civilian Neck Zone II Vascular Trauma
Neck trauma is the leading cause of death in younger persons, posing to surgeons the dilemma whether to proceed with reconstruction of vascular injuries either in the presence of coma or in severe neurological deficit [1]
Cervical vascular injury in zone II remains till today the most common following blunt/penetrating neck trauma posing the surgeon in the situation to make a rapid decision to salvage patient’s life
Summary
Received: 31 March 2017 Accepted: 08 September 2017 Published: 29 September 2017. Citation: Karaolanis G, Maltezos K, Bakoyiannis C and Georgopoulos S (2017) Contemporary Strategies in the Management of Civilian Neck Zone II Vascular Trauma. Neck trauma is the leading cause of death mainly in younger persons posing to surgeons the dilemma whether to proceed with reconstruction of vascular injuries either in the presence of coma or in severe neurological deficit. Conventional open repair of carotid injuries with primary closure or interposition grafting is always recommended due to the effective long-term results for penetrating injuries or for patients unfit for endovascular intervention. In cases of blunt trauma, anticoagulation or antiplatelet therapy should be administered first in neurologically stable patients. In case of worsening of the neurological status of the patient despite adequate anticoagulation endovascular means should be considered in cases of appropriate anatomy of the arterial trauma. We provide an update on penetrating/blunt trauma in zone II of the neck, giving emphasis on the anticoagulant and endovascular treatment
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