INTERVENTIONAL RADIOLOGY IN THE TREATMENT OF INTERNAL CAROTID-ARTERY GUNSHOT WOUNDS

PURPOSE: To review the indications for and techniques and results of i nterventional radiology in the management of internal carotid artery g unshot wounds. PATIENTS AND METHODS: The demographics, clinical presen tations, angiographic findings, methods of treatment, and outcomes wer e reviewed in 20 patients who underwent 21 interventional procedures. RESULTS: Seventeen coil embolizations were successful in controlling h emorrhage. One intimal flap was compressed with balloon angioplasty, w ith subsequent nonoperative healing, Temporary balloon occlusions were used as a method of preoperative assessment of intracranial collatera l circulation or of preoperative vascular control in three patients, T here were no complications, The mortality rate was 20%. CONCLUSION: Pe netration of the internal carotid artery is a very severe injury with a high mortality rate due to neurologic sequelae, Interventional radio logy plays an important role in the management of these wounds, and it often obviates surgical exploration.