Abstract

Objective: To share the clinical presentation, vascular injury pattern and surgical management of carotid injuries.
Methodology: This cross-sectional qualitative study was conducted at CMH Lahore and Multan from June 2023 to December 2024. It included all consecutive patients with carotid trauma (non-purposive consecutive sampling). The demographics, mode of presentation, injury type, surgical repair and postoperative complications were recorded.
Results: There were 21 (males 19, females 2) patients with mean age of 35.9±11.7 years. Mean time from injury to intervention was 7.83±6.11 hours. Penetrating trauma was the most common mode of injury (62%). Linear tear was commonest injury (38%) followed by transection (19%). Contusion with intravascular thrombosis, tear with partial loss of vessel wall and puncture wound was found in 14% (n=3) each. Hard signs were present in 62% (n=13) and 38% (n=8) had soft signs. Primary repair was performed in 28.5% (n=6), interposition grafting in 33% (n=7), patch repair and ligation in 14% (n=3) each and external to internal carotid artery transposition in 9.5% (n=2). Temporary intravascular arterial shunting (TIVAS) was done in 52% (n=11) patients.
Conclusion: Penetrating trauma to the carotid vessel is most common vascular trauma of neck. Interposition grafting is the safest of the repairs with minimal complications followed by primary repair of the vessel.

Key words: Carotid, cervical, injury, neck, trauma, vascular.