Is definitive vascular reconstruction of carotid arteries justified during a mass casualty event?

Abstract

A critically wounded 23-year-old woman was oneof numerous passengers injured by shrapnel andblast during a suicide terror attack on a bus. SpiralCTand formal angiography revealed bilateral com-mon carotid perforating injuries and false aneurysmat the origin of the innominate artery. The intra-operative findings also included right internal jugu-lar vein transection and lateral tear of the leftinternal jugular vein. These injuries were repairedby a multidisciplinary surgical team approach usingvarious reconstructive techniques.