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Damage control in penetrating carotid artery trauma: changing a 100-year paradigm
Carotid artery trauma carries a high risk of neurological sequelae and death. Surgical management of these injuries has been controversial because it entails deciding between repair or ligation of the vessel, for which there is still no true consensus either way. This article proposes a new manageme...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Universidad del Valle
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8634279/ https://www.ncbi.nlm.nih.gov/pubmed/34908620 http://dx.doi.org/10.25100/cm.v52i2.4807 |
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author | Serna, José Julián Ordoñez, Carlos A. Parra, Michael W. Serna, Carlos Caicedo, Yaset Rosero, Alberto Velásquez, Fernando Serna, Carlos Salcedo, Alexander González-Hadad, Adolfo García, Alberto Herrera, Mario Alain Pino, Luis Fernando Franco, Maria Josefa Rodríguez-Holguín, Fernando |
author_facet | Serna, José Julián Ordoñez, Carlos A. Parra, Michael W. Serna, Carlos Caicedo, Yaset Rosero, Alberto Velásquez, Fernando Serna, Carlos Salcedo, Alexander González-Hadad, Adolfo García, Alberto Herrera, Mario Alain Pino, Luis Fernando Franco, Maria Josefa Rodríguez-Holguín, Fernando |
author_sort | Serna, José Julián |
collection | PubMed |
description | Carotid artery trauma carries a high risk of neurological sequelae and death. Surgical management of these injuries has been controversial because it entails deciding between repair or ligation of the vessel, for which there is still no true consensus either way. This article proposes a new management strategy for carotid artery injuries based on the principles of damage control surgery which include endovascular and/or traditional open repair techniques. The decision to operate immediately or to perform further imaging studies will depend on the patient's hemodynamic status. If the patient presents with massive bleeding, an expanding neck hematoma or refractory hypovolemic shock, urgent surgical intervention is indicated. An altered mental status upon arrival is a potentially poor prognosis marker and should be taken into account in the therapeutic decision-making. We describe a step-by-step algorithmic approach to these injuries, including open and endovascular techniques. In addition, conservative non-operative management has also been included as a potentially viable strategy in selected patients, which avoids unnecessary surgery in many cases. |
format | Online Article Text |
id | pubmed-8634279 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Universidad del Valle |
record_format | MEDLINE/PubMed |
spelling | pubmed-86342792021-12-13 Damage control in penetrating carotid artery trauma: changing a 100-year paradigm Serna, José Julián Ordoñez, Carlos A. Parra, Michael W. Serna, Carlos Caicedo, Yaset Rosero, Alberto Velásquez, Fernando Serna, Carlos Salcedo, Alexander González-Hadad, Adolfo García, Alberto Herrera, Mario Alain Pino, Luis Fernando Franco, Maria Josefa Rodríguez-Holguín, Fernando Colomb Med (Cali) Review Carotid artery trauma carries a high risk of neurological sequelae and death. Surgical management of these injuries has been controversial because it entails deciding between repair or ligation of the vessel, for which there is still no true consensus either way. This article proposes a new management strategy for carotid artery injuries based on the principles of damage control surgery which include endovascular and/or traditional open repair techniques. The decision to operate immediately or to perform further imaging studies will depend on the patient's hemodynamic status. If the patient presents with massive bleeding, an expanding neck hematoma or refractory hypovolemic shock, urgent surgical intervention is indicated. An altered mental status upon arrival is a potentially poor prognosis marker and should be taken into account in the therapeutic decision-making. We describe a step-by-step algorithmic approach to these injuries, including open and endovascular techniques. In addition, conservative non-operative management has also been included as a potentially viable strategy in selected patients, which avoids unnecessary surgery in many cases. Universidad del Valle 2021-06-30 /pmc/articles/PMC8634279/ /pubmed/34908620 http://dx.doi.org/10.25100/cm.v52i2.4807 Text en Copyright © 2021 Colombia Medica https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) ), which permits unrestricted use and redistribution provided that the original author and source are credited. |
spellingShingle | Review Serna, José Julián Ordoñez, Carlos A. Parra, Michael W. Serna, Carlos Caicedo, Yaset Rosero, Alberto Velásquez, Fernando Serna, Carlos Salcedo, Alexander González-Hadad, Adolfo García, Alberto Herrera, Mario Alain Pino, Luis Fernando Franco, Maria Josefa Rodríguez-Holguín, Fernando Damage control in penetrating carotid artery trauma: changing a 100-year paradigm |
title | Damage control in penetrating carotid artery trauma: changing a 100-year paradigm |
title_full | Damage control in penetrating carotid artery trauma: changing a 100-year paradigm |
title_fullStr | Damage control in penetrating carotid artery trauma: changing a 100-year paradigm |
title_full_unstemmed | Damage control in penetrating carotid artery trauma: changing a 100-year paradigm |
title_short | Damage control in penetrating carotid artery trauma: changing a 100-year paradigm |
title_sort | damage control in penetrating carotid artery trauma: changing a 100-year paradigm |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8634279/ https://www.ncbi.nlm.nih.gov/pubmed/34908620 http://dx.doi.org/10.25100/cm.v52i2.4807 |
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