Download PDF
Zentralbl Chir 2003; 128(2): 150-154
DOI: 10.1055/s-2003-37769
Originalarbeiten und Übersichten

© Georg Thieme Verlag Stuttgart · New York

Traumatische Dissektion der linken Arteria carotis interna durch stumpfes Trauma: Behandlung mittels endovaskulärer Stent-Versorgung

Internal Carotid Artery Dissection at the Carotid Canal After Blunt Trauma: Case Report of Endovascular Repair and Literature ReviewK. Mader1 , M. Gawenda2 , M. Zähringer2 , K. Lackner2 , J. Brunkwall2
  • 1St. Vinzenz-Hospital, Köln
  • 2Gefäßzentrum des Klinikums der Universität Köln
Further Information

Publication History

Publication Date:
11 March 2003 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Symptomatische Dissektionen der extrakraniellen Art. carotis interna nach stumpfem Trauma sind selten. Die medikamentöse Behandlung dieser Verletzungen ist häufig nicht effektiv, die chirurgische Therapie weist eine hohe Morbidität auf. Wir stellen den Fall einer erfolgreichen endovaskulären Behandlung einer traumatischen Dissektion der extrakraniellen Art. carotis interna mittels eines selbst-expandierenden Stents vor. Die Vorteile des endovaskulären Vorgehens werden dargestellt und die aktuelle Literatur zur stumpfen Verletzung der Art. carotis interna und ihre Behandlungskonzepte diskutiert.

Abstract

Symptomatic dissecting aneurysms of the extracranial internal carotid artery after blunt trauma are not frequent. Medical treatment of these lesions can be ineffective and surgical options present high morbidity. We describe a case successfully treated with endovascular therapy, using a self-expanding stent. The advantages of the endovascular treatment are outlined, the literature on carotid artery injuries by blunt trauma and management strategies are reviewed.

Schlüsselwörter

Art. carotis interna - stumpfes Trauma - endovaskuläre Behandlung

Key words

Internal carotid artery - blunt trauma - endovascular treatment

Literatur

  • 1 Ahn S H, Cutry A C, Mruphy T P, Slaiby J M. Traumatic aortic rupture: treatment with endovascular graft in the acute setting.  J Trauma. 2001;  50 949-951
    PubMedSearch in Google Scholar
  • 2 Bejjani G K, Monsein L H, Laird J R, Satler L F, Starnes B W, Aulisi E F. Treatment of symptomatic cervical carotid dissections with endovascular stents.  Neurosurgery. 1999;  44 755-761
    PubMedSearch in Google Scholar
  • 3 Bernstein S M, Coldwell D M, Prall J A, Brega K E. Treatment of traumatic carotid pseudoaneurysm with endovascular stent placement.  J Vasc Interv Radiol. 1997;  8 1065-1068
    PubMedSearch in Google Scholar
  • 4 Biffl W L, Moore E E, Offner P J, Brega K E, Franciose R J, Burch J M. Blunt carotid arterial injuries: Implicaitons of a New grading scale.  J Trauma. 1999;  47 845-853
    CrossrefPubMedSearch in Google Scholar
  • 5 Biffl. et al . Letter: Emergent stenting of acute blunt carotid artery injuries: a cautionary note.  J Trauma. 2000;  50 969-970
    PubMedSearch in Google Scholar
  • 6 Biousse V, D'Angeljan-Chatillon J. et al . Time course of symptoms in extracranial carotid artery dissections.  Stroke. 1995;  26 235-239
    CrossrefPubMedSearch in Google Scholar
  • 7 Castellan L, Casasco A, Toso V, Bernardi L. Stenting of the extracranial internal carotid artery for dissecting aneurysm.  Ital J Neurol Sci. 1999;  20 251-253
    CrossrefPubMedSearch in Google Scholar
  • 8 Criado E, Marston W A, Ligush J, Marua M A, Keagy B A. Endovascular repair of peripheral aneurysms, pseudoaneurysms and arteriovenous fistulas.  Ann Vasc Surg. 1997;  11 26-263
    PubMedSearch in Google Scholar
  • 9 Cogbill T, Moore E, Meissner M. et al . The spectrum of blunt injury to the carotid artery: A multicenter prospective.  J Trauma. 1994;  37 473-479
    CrossrefPubMedSearch in Google Scholar
  • 10 Coldwell. et al . Treatment of post-traumatic internal carotid pseudoaneurysms with endovascular stents.  J Trauma. 2000;  48 470-472
    CrossrefPubMedSearch in Google Scholar
  • 11 Davis J, Holbrook T, Hoyt D. et al . Blunt carotid artery dissection: incidence, associated injuries, screening and treatment.  J Trauma. 1990;  30 1514-1517
    CrossrefPubMedSearch in Google Scholar
  • 12 DeOcampo J, Brillman J, Lefy D I. Stenting: a new approach to carotid dissection.  J Neuroimaging. 1997;  7 187-190
    PubMedSearch in Google Scholar
  • 13 Diethrich E B, Ndiaye M, Reid D. Stenting in the carotid artery: initial experience in 110 patients.  J Endovasc Surg. 1996;  3 42-46
    CrossrefPubMedSearch in Google Scholar
  • 14 Dorros G, Cohn J M, Palmer L E. Stent deployment resolves a petrous carotid artery angioplasty dissection.  AJNR Am J Neuroradiol.. 1998;  19 392-394
    PubMedSearch in Google Scholar
  • 15 Duke B J, Ryu R K, Coldwell D M, Brega K E. Treatment of blunt injury to the carotid artery by using endovascular stents: an early experience.  J Neurosurg. 1997;  87 825-829
    CrossrefPubMedSearch in Google Scholar
  • 16 Fabian T C, Patton JH J r, Croce M A. et al . Blunt carotid trauma. Importance of early diagnosis and anticoagulant therapy.  Ann Surg. 1996;  223 513-535
    CrossrefPubMedSearch in Google Scholar
  • 17 Fujikawa T, Yukioka T, Ishimaru S, Kanai M, Muraoka A, Sasaki H, Honma H, Koike S, Kawaguchi S. Endovascular stent grafting for the treatment of blunt thoracic aortic injury.  J Trauma. 2001;  50 223-229
    PubMedSearch in Google Scholar
  • 18 Horowitz M B, Miller G III, Meyer Y, Carstents G III, Purdy P D. Use of intravascular stents in the treatment of internal carotid and extracranial verabral artery pseudoaneurysms.  AJNR Am J Neuroradiol. 1996;  17 693-696
    PubMedSearch in Google Scholar
  • 19 Kerby. et al . Treatment of bilateral blunt carotid injury using percutaneous angioplasty and stenting: a case report and review of the literature.  J Trauma. 2000;  49 784-787
    PubMedSearch in Google Scholar
  • 20 Little J, May J, Vanderfield G. et al . Traumatic thrombosis of the internal carotid artery.  Lancet. 1967;  2 926-930
    PubMedSearch in Google Scholar
  • 21 Liu A Y, Paulsen R D, Marcellus M L, Steinberg G K, Marks M P. Long-term outcome after carotid stent placement for treatment of caroted artery disection.  Neurosurgery. 1999;  45 1368-1373
    CrossrefPubMedSearch in Google Scholar
  • 22 Marin M L, Veith F J, Panetta T F. et al . Transluminal placed endovascular stented graft repair for arterial trauma.  J Vasc Surg. 1994;  20 466-473
    CrossrefPubMedSearch in Google Scholar
  • 23 Marotta T R, Buller C, Taylor D, Morris C, Zwimpfer T. Autologous vein-covered stent repair of a cervical internal carotid artery pseudoaneurysms: technical case report.  Neurosurgery. 1998;  42 408-413
    PubMedSearch in Google Scholar
  • 24 Marks M P, Dake M D, Stenberg G K, Norbash A M, Lane B. Stent placement for arterial and venous cerebrovascular disease: Preliminary experience.  Radiology. 1994;  191 441-446
    PubMedSearch in Google Scholar
  • 25 Mase M, Banno T, Yamada K, Katano H. Endovascular stent placement for multiple aneurysms of the extracranial internal carotid artery: technical case report.  Neurosurgery. 1995;  37 832-835
    PubMedSearch in Google Scholar
  • 26 Matsuura J H, Rosenthal D, Jerius H, Clark M D, Owens D S. Traumatic carotid artery dissection and pseudoaneurysm treated with endovascular coils and stent.  J Endovasc Surg. 1997;  4 339-343
    CrossrefPubMedSearch in Google Scholar
  • 27 Mokri B, Piepgras D, Houser O. Traumatic dissections of the extracranial internal carotid artery.  J Neurosurg. 1988;  68 189-197
    CrossrefPubMedSearch in Google Scholar
  • 28 New P F, Mamose K J. Traumatic dissection of the internal carotid artery at the atlantoaxial level, secondary to nonpenetrating injury.  Radiology. 1969;  168 727-731
    PubMedSearch in Google Scholar
  • 29 Ofer A, Nitecki S S, Braun J, Daitzchman M, Goldsher D, Hoffman A, Engel A. CT angiography of the carotid arteries in trauma to the neck.  Eur J Vasc Endovasc Surg. 2001;  21 401-407
    CrossrefPubMedSearch in Google Scholar
  • 30 Ohki T, Veith F J, Marin M L, Cynamon J, Sanchez L A. Endovascular approaches for traumatic arterial lesions.  Semin Vasc Surg. 1997;  10 272-285
    PubMedSearch in Google Scholar
  • 31 Parodi J C, Palmaz J C, Barone H D. Transfemoral intraluminal graft implantation for abdominal aortic aneurysms.  Ann Vasc Surg. 1991;  5 491-499
    CrossrefPubMedSearch in Google Scholar
  • 32 Parodi J C, Schonholz C, Ferreira L M, Bergan J. Endovascular stent-graft treatment of traumatic arterial lesions.  Ann Vasc Surg. 1999;  13 121-129
    CrossrefPubMedSearch in Google Scholar
  • 33 Patel A V, Marin M L, Veith F J, Kerr A, Sanchez L A. Endovascular graft repair of penetrating subclavian artery injuries.  J Endovasc Surg. 1996;  3 382-388
    CrossrefPubMedSearch in Google Scholar
  • 34 Perez-Cruet M J, Patwardhan R V, Mawad M E, Rose J E. Treatment of dissecting pseudoaneurysm of the cervical internal carotid artery using a wall stent and detachable coils: case report.  Neurosurgery. 1997;  40 622-626
    PubMedSearch in Google Scholar
  • 35 Perry M O, Snyder W H, Thal E R. Carotid artery injuries caused by blunt trauma.  Ann Surg. 1980;  192 74-77
    PubMedSearch in Google Scholar
  • 36 Ramadan F, Rutlege R, Oller D. et al . Carotid artery trauma: a review of contemporary trauma center experiences.  J Vasc Surg. 1995;  21 46-56
    CrossrefPubMedSearch in Google Scholar
  • 37 Roubin G S, Yadav S, Iyer S S, Vitek J. Carotid stent- supported angioplasty: A neurovascular intervention to prevent stroke.  Am J Cardiol. 1996;  78 8-12
    PubMedSearch in Google Scholar
  • 38 Ruebben A, Merlo M. et al .Exclusion of an internal carotid aneurysm by a covered stent. J Cardiovasc Surg 38: 301 - 303
  • 39 Sanchez L A, Veith F J, Ohki T. et al . Early experience with the Corvita endoluminal graft for arterial injuries.  Ann Vasc Surg. 1999;  13 151-157
    CrossrefPubMedSearch in Google Scholar
  • 40 Schievenk W I, Piepgras D G. et al . Surgical treatment of extracranial internal carotid artery dissecting aneurysms.  Neurosurgery. 1994;  35 809-815
    PubMedSearch in Google Scholar
  • 41 Trent M S, Parsonnet V, Shoenfeld R. et al . A ballon-expandable intravascular stent for obliterating experimental aortic dissection.  J Vasc Surg. 1990;  11 707-717
    PubMedSearch in Google Scholar
  • 42 Wastridge C, Muhlbauer M, Lowery R. Traumatic carotid artery dissection: diagnosis and management.  J Neurosurg. 1989;  71 854-857
    PubMedSearch in Google Scholar
  • 43 Wholey M H, Jarmolowski C R, Eles G E, Levy D, Buecthel J. Endovascular Stents for carotid artery occlusive disease.  J Endovasc Surg. 1997;  4 326-338
    CrossrefPubMedSearch in Google Scholar
  • 44 Vernhet H, Marty- Ane C H, Lesnik A. et al . Dissection of the abdominal aorta in blunt trauma: management by percutaneous stent placement.  Cardiovasc Intervent Radiol. 1997;  20 473-476
    CrossrefPubMedSearch in Google Scholar
  • 45 Yamada S, Kindt G, Youmans J. Carotid artery occlusion due to nonpenetrating injury.  J Trauma. 1967;  7 33-42
    PubMedSearch in Google Scholar

Dr. med. Konrad Mader

Klinik für Unfallchirurgie, Hand- und Wiederherstellungschirurgie . St. Vinzenz-Hospital

Merheimer Str. 221-223

50733 Köln

Phone: 02 21/77 12-3 67

Email: k.mader@ndh.net