Combined Carotid-Vertebral Arterial Trauma

Eight patients with simultaneous penetrating trauma to the carotid and vertebral arteries among 129 carotid and 53 vertebral arterial injuries have been treated in the last 14 years. In contrast to a 10% mortality with isolated carotid or vertebral trauma, the mortality associated with this injury complex was 50%. This high mortality directly related to the overall complexity of the trauma sustained by these patients. The liberal use of arteriography to assess penetrating cervical trauma has enhanced the diagnosis of these injuries. We recommend simultaneous surgical management of the carotid and vertebral arterial injury through an extended anterior cervical approach.