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. 2022 Dec 5;9(2):101073.
doi: 10.1016/j.jvscit.2022.10.021. eCollection 2023 Jun.

Transcarotid artery revascularization in blunt carotid injury

Patrick F Walker  1 , Grahya C Guntur  1 , Priti Lalchandani  1 , Jonathan J Morrison  2 , Rishi Kundi  1
Affiliations

Transcarotid artery revascularization in blunt carotid injury

Patrick F Walker et al. J Vasc Surg Cases Innov Tech. .

Abstract

Introduction: Transcarotid artery revascularization (TCAR) with flow reversal has substantially changed the management of carotid artery stenosis, enabling an endovascular approach with a periprocedural stroke rate as low as or lower than that of open carotid surgery. The use of TCAR for blunt carotid artery injury has not yet been described.

Methods: A review of the use of TCAR for blunt carotid artery injury was performed at a single center from October 2020 to August 2021. The patient demographics, mechanism of injury, and outcomes were collected and compared.

Results: Ten carotid stents were placed via TCAR in eight patients for hemodynamically significant blunt carotid artery injuries. No periprocedural neurologic events occurred, and all stents remained patent during short-term follow-up.

Conclusions: TCAR is feasible and safe in the management of significant blunt carotid artery injuries. More data are needed regarding the long-term outcomes and ideal surveillance intervals.

Keywords: Blunt cerebrovascular injury; Transcarotid artery revascularization.

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Figures

Fig 1
Fig 1
University of Maryland R. Adams Cowley Shock Trauma Center carotid blunt cerebrovascular injury (BCVI) algorithm. CTA, Computed tomography angiography; TCAR, transcarotid artery revascularization.
Fig 2
Fig 2
Illustration showing transcarotid artery revascularization (TCAR) flow reversal circuit.
Fig 3
Fig 3
Illustration showing stent deployment through transcarotid artery revascularization (TCAR) sheath with wire access across the lesion and clamping across the proximal common carotid artery.
Fig 4
Fig 4
Patient and injury characteristics. N/A, Not applicable.
Fig 5
Fig 5
Representative angiograms before and after carotid stent deployment during transcarotid artery revascularization (TCAR).
See this image and copyright information in PMC

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