Journal article
Grade 1 Internal Carotid Artery Blunt Cerebrovascular Injury Persistence Risks Stroke With Current Management: An EAST Multicenter Study
The American surgeon, v 89(6), pp 2618-2627
Jun 2023
PMID: 35652129
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Higher blunt cerebrovascular injury (BCVI) grade and lack of medical therapy are associated with stroke. Knowledge of stroke risk factors specific to individual grades may help tailor BCVI therapy to specific injury characteristics.
A post-hoc analysis of a 16 center, prospective, observational trial (2018-2020) was performed including grade 1 internal carotid artery (ICA) BCVI. Repeat imaging was considered the second imaging occurrence only.
From 145 grade 1 ICA BCVI included, 8 (5.5%) suffered a stroke. Grade 1 ICA BCVI with stroke were more commonly treated with mixed anticoagulation and antiplatelet therapy (75.0% vs 9.6%, P <.001) and less commonly antiplatelet therapy (25.0% vs 82.5%, P = .001) compared to injuries without stroke. Of the 8 grade 1 ICA BCVI with stroke, 4 (50.0%) had stroke after medical therapy was started. In comparing injuries with resolution at repeat imaging to those without, stroke occurred in 7 (15.9%) injuries without resolution and 0 (0%) injuries with resolution (P = .005). At repeat imaging in grade 1 ICA BCVI with stroke, grade of injury was grade 1 in 2 injuries, grade 2 in 3 injuries, grade 3 in 1 injury, and grade 5 in one injury.
While the stroke rate for grade 1 ICA BCVI is low overall, injury persistence appears to heighten stroke risk. Some strokes occurred despite initiation of medical therapy. Repeat imaging is needed in grade 1 ICA BCVI to evaluate for injury progression or resolution.
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Details
- Title
- Grade 1 Internal Carotid Artery Blunt Cerebrovascular Injury Persistence Risks Stroke With Current Management: An EAST Multicenter Study
- Creators
- Sarah Yang - University of Maryland, BaltimoreEmily Esposito - University of Maryland, BaltimoreChance Spalding - Grant Medical CenterJoshua Simpson - Prisma HealthJulie 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 - Lehigh Valley Hospital-PoconoRachel Appelbaum - Lehigh Valley Hospital-PoconoNikolay 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, BaltimoreMargaret Lauerman - University of Maryland, Baltimore
- Publication Details
- The American surgeon, v 89(6), pp 2618-2627
- Publisher
- Sage
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000806976600001
- Scopus ID
- 2-s2.0-85131545253
- Other Identifier
- 991022020737304721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Surgery