Treatment of posttraumatic internal carotid arterial pseudoaneurysms with endovascular stents

Background: The sequelae of blunt injury to the carotid arteries are unusua l, but pseudoaneurysms causing subsequent strokes are devastating. The util ity of treatment of these pseudoaneurysms was examined, Methods: All patients at a Level I trauma center with previously documented traumatic risk factors were assessed for blunt injury to the carotid arter ies and, when a pseudoaneurysm was present, a self-expanding metallic stent was placed across the lesion and the patient plated on anticoagulation. Fo llow-up arteriograms were obtained in 2 months and every 6 months thereafte r, Results: Fourteen patients (7 men, 7 women) with an average age of 27 years , an Injury Severity Score of 38, had formed pseudoaneurysms in 16 extracra nial internal carotid arteries. These were stented with metallic endoprosth eses. No strokes occurred after the placement of the stents, Mean follow-up period has been 2.5 years. Conclusions: Use of metallic endoprostheses is an effective method to treat this potentially devastating; injury. However, longer follow-up and more p atients studied are needed to further examine this promising treatment.