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Emergency endovascular management of a shrapnel injury to the left common carotid artery with impending blow-out
  1. Rohit Mehra,
  2. V Patra,
  3. R Dhillan and
  4. M Jha
  1. Department of Vascular Surgery, Army Hospital Research and Referral, New Delhi, Delhi, India
  1. Correspondence to Rohit Mehra, Department of Vascular Surgery, Army Hospital Research and Referral, New Delhi 110010, Delhi, India; capocrimini.rohit{at}gmail.com

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Post-traumatic extracranial carotid artery pseudoaneurysms have been reported to have an incidence rate of 0.02%–0.4%.1 The anatomical location with associated injuries makes the management challenging. The challenge further multiplies in the hostile environment of low-intensity conflict as seen by combat surgeons. Endovascular stent grafting of the injured segment has emerged as a feasible alternative to the more morbid open surgical procedure in such situations. Diagnostic and therapeutic usuage of endovascular interventions, including stenting and angioplasty has been reported oflate in vascular injuries sustained in combat 2 Here we present the successful endovascular management of a case of post-traumatic carotid artery pseudoaneurysm with impending blow-out.

A 28-year-old man sustained shrapnel injury to the left side of his neck in a hostile conflict zone. After initial on-site fluid resuscitation and pressure tamponade, he was evacuated to an advanced medical echelon where on primary survey the entry wound was found in zone 1 of the left side of his neck and he was found to be in class I haemorrhagic shock, with soft signs such as hoarseness of voice and a non-expanding left-side neck haematoma. CT …

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Footnotes

  • Contributors RM was involved in planning and prepared the first and final manuscript. VP was involved in planning, surgical execution and data collection. RD reviewed the manuscript. MJ was involved in planning and data collection. RM is the guarantor of the study.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.