American Association for the Surgery of Trauma—World Society of Emergency Surgery Guidelines on the diagnosis and management of cervical vascular injuries

American Association for the Surgery of Trauma-World Society of Emergency Surgery Guidelines on the diagnosis and management of cervical vascular injuries Cervical vascular injuries comprise 10% of all vascular trauma, equally affecting adult and pediatric patients. Approximately 65% occur after penetrating trauma and 35% after blunt trauma.1,2 Untreated, blunt cerebrovascular injury (BCVI) results in stroke in up to 20% of patients, causing devastating neurologic consequences.3,4 In one multicenter study, 37% of strokes were present on initial evaluation; the rest occurred at a median of 48 hours after admission.5 This underscores the importance of adopting evidence-based screening protocols for blunt trauma patients for expeditious assessment of at-risk patients and early initiation of antithrombotic therapy (AT). Arterial injury occurs in up to 25% of penetrating neck trauma and has a mortality rate of up to 20% due to stroke and hemorrhage.6,7 Rapid assessment, bleeding control, and restoration of cerebrovascular blood flow are critical to minimize morbidity and mortality. The purpose of this article is to provide the American Association for the Surgery of Trauma (AAST) and the World Society of Emergency Surgery (WSES) recommendations for the diagnosis and management of cervical vascular injuries (CVI).