Emergency endovascular interventions of traumatic cranial and extracranial injuries

Traumatic head and neck, and cerebrovascular injuries may result in a devastating consequence of vascular injuries involving the major cervical and cerebral vessels, potentially leading to hemorrhage, stroke, or death. Vascular injury may result in vessel transection, laceration, false aneurysm, arteriovenous fistula, or thrombosis. Massive hemorrhage may occur secondary to blunt, penetrating, or iatrogenic trauma. Surgical treatment, while at times curative, cannot always be performed, particularly when the location of the injury or the patient's unstable condition precludes surgical options. Endovascular treatment options include the use of uncovered or covered stents, endovascular coils and balloons, as well as liquid or solid embolic materials in reconstructing damaged arterial lumens, controlling pseudoaneurysm formation or lacerations, or when necessary, vessel sacrifice. The authors describe recent and ongoing developments in endovascular techniques and illustrate treatments that are currently available to the interventionalist for repair of these traumatic lesions.