Endovascular Management of Blast-Related Head and Neck Vascular Injuries
How do you control carotid bleeding located one centimetre from the skull base, manage a fragment penetrating the vessel lumen, or decide whether an injured vertebral artery should be reconstructed or sacrificed?
Ivan Dorih presents real cases of blast and penetrating head and neck trauma treated at a military hospital near Kharkiv. The lecture connects the Denver grading scale with practical decisions: observation and antithrombotic therapy, urgent stent-graft placement, embolisation, thrombectomy, vessel sacrifice, or a hybrid open and endovascular approach.
The session also explores the diagnostic value of CT angiography, selective cerebral angiography and CT perfusion; interpretation of ischaemic core and penumbra; selection of self-expanding and heparin-bonded stent grafts; and antiplatelet strategies when major surgery and bleeding risks compete. The clinical details reveal why apparently minor findings, metallic artefacts and delayed vascular complications can radically change the treatment plan.
Ivan Dorih presents real cases of blast and penetrating head and neck trauma treated at a military hospital near Kharkiv. The lecture connects the Denver grading scale with practical decisions: observation and antithrombotic therapy, urgent stent-graft placement, embolisation, thrombectomy, vessel sacrifice, or a hybrid open and endovascular approach.
The session also explores the diagnostic value of CT angiography, selective cerebral angiography and CT perfusion; interpretation of ischaemic core and penumbra; selection of self-expanding and heparin-bonded stent grafts; and antiplatelet strategies when major surgery and bleeding risks compete. The clinical details reveal why apparently minor findings, metallic artefacts and delayed vascular complications can radically change the treatment plan.