Journal article
Endovascular Intervention in Internal Carotid Artery Blunt Cerebrovascular Injury: An EAST Multicenter Study
The American surgeon, v 88(8), pp 1962-1969
01 Aug 2022
PMID: 35437020
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background Use of endovascular intervention (EI) for blunt cerebrovascular injury (BCVI) is without consensus guidelines. Rates of EI use and radiographic characteristics of BCVI undergoing EI nationally are unknown. Methods A post-hoc analysis of a prospective, observational study at 16 U.S. trauma centers from 2018 to 2020 was conducted. Internal carotid artery (ICA) BCVI was included. The primary outcome was EI use. Multivariable logistic regression was performed for predictors of EI use. Results From 332 ICA BCVI included, 21 (6.3%) underwent EI. 0/145 (0%) grade 1, 8/101 (7.9%) grade 2, 12/51 (23.5%) grade 3, and 1/20 (5.0%) grade 4 ICA BCVI underwent EI. Stroke occurred in 6/21 (28.6%) ICA BCVI undergoing EI and in 33/311 (10.6%) not undergoing EI (P = .03), with all strokes with EI use occurring prior to or at the same time as EI. Percentage of luminal stenosis (37.75 vs 20.29%, P = .01) and median pseudoaneurysm size (9.00 mm vs 3.00 mm, P = .01) were greater in ICA BCVI undergoing EI. On logistic regression, only pseudoaneurysm size was associated with EI (odds ratio 1.205, 95% CI 1.035-1.404, P = .02). Of the 8 grade 2 ICA BCVI undergoing EI, 3/8 were grade 2 and 5/8 were grade 3 prior to EI. Of the 12 grade 3 ICA BCVI undergoing EI, 11/12 were grade 3 and 1/12 was a grade 2 ICA BCVI prior to EI. Discussion Pseudoaneurysm size is associated with use of EI for ICA BCVI. Stroke is more common in ICA BCVI with EI but did not occur after EI use.
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Details
- Title
- Endovascular Intervention in Internal Carotid Artery Blunt Cerebrovascular Injury: An EAST Multicenter Study
- Creators
- Margaret Lauerman - University of Maryland, BaltimoreEmily Esposito - University of Maryland, BaltimoreChance Spalding - Grant Medical CenterJoshua Simpson - University of Maryland, BaltimoreJulie A. Dunn - HeskaLinda Zier - HeskaSigrid Burruss - Loma Linda UniversityPaul Kim - Loma Linda UniversityLewis E. Jacobson - AscensionJamie Williams - AscensionJeffry Nahmias - University of California, IrvineAreg Grigorian - University of California, IrvineLaura Harmon - University of Colorado DenverAnna Gergen - University of Colorado DenverMatthew Chatoor - University of MiamiRishi Rattan - University of MiamiAndrew J. Young - University of PennsylvaniaJose L. Pascual - University of PennsylvaniaJason Murry - The University of Texas Health Science Center at TylerAdrian W. Ong - Reading HospitalAlison Muller - Reading HospitalRovinder S. Sandhu - University of Maryland, BaltimoreRachel Appelbaum - University of Maryland, BaltimoreNikolay Bugaev - Tufts UniversityAntony Tatar - Tufts UniversityKhaled Zreik - Sanford HealthMark J. Lieser - Research Medical CenterThomas M. Scalea - University of Maryland, BaltimoreDeborah M. Stein - University of Maryland, Baltimore
- Publication Details
- The American surgeon, v 88(8), pp 1962-1969
- Publisher
- Sage
- Number of pages
- 8
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000784193500001
- Scopus ID
- 2-s2.0-85129241590
- Other Identifier
- 991022020737904721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Surgery