Management of Major Vascular Injuries in the Base of the Neck

Abstract

The authors reviewed the cases of 146 patients with 206 injuries to the major vessels at the base of the neck, the common carotid, subclavian, and innominate arteries and their accompanying veins. The predominate injury was arterial in 49% of the patients. Forty-five patients, or 32% of the series, showed no diagnostic signs. These patients were explored because of penetrating trauma in proximity to a major vessel, confirming the validity of this concept. The operative approach to injuries in this region is described. Vascular control and repair was usually possible, using the oblique cervical or horizontal clavicular incision with resection of the medial half of the clavicle. Eleven patients died, yielding an overall mortality of 7.5%.