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Abstract
The English-language literature, from 1952 to 1979, was surveyed for all papers concerned
with vascular trauma, penetrating wounds of the neck, or carotid injuries in particular,
and all valid, first-hand, adequately detailed cases of carotid arterial trauma were
abstracted. The current status of all our own hospital survivors who had been treated
for carotid artery injuries was also established to add needed longitudinal perspective.
In all, 722 cases were available for analysis. The mean age was 28 years, and the
overall mortality rate was 21%. One hundred and eighty-six patients presented with
severe neurological deficits. If they underwent arterial repair, 34% were better;
if they had a carotid ligated, or were not treated surgically, only 14% improved (P
= 0.01). Shock or coma, independently, were significantly ominous (P < 0.001), but
there was no evidence to support coma as a contraindication to restoring arterial
continuity. Similarly, in the patients with preoperative neurological deficits, no
data could be found to substantiate the contention that prompt arterial repair would
yield better results than delayed repair. Follow-up status at 1 year was available
for only 40 cases from the entire literature. Assessment of our own patients, at a
mean of 4.6 years after injury, uncovered multiple, persistent neurological defects,
one stenotic arterial repair, two aneurysms, and an arteriovenous fistula.
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Article info
Publication history
Accepted:
January 29,
1980
Identification
Copyright
© 1980 Published by Elsevier Inc.
