Abstract：
BACKGROUND: Use of endovascular intervention (EI) for blunt cerebrovascular injury (BCVI) is without consensus guidelines. Rates of EI use and radiographic characteristics of BCVI undergoing EI nationally are unknown.
METHODS: A post-hoc analysis of a prospective, observational study at 16 U.S. trauma centers from 2018 to 2020 was conducted. Internal carotid artery (ICA) BCVI was included. The primary outcome was EI use. Multivariable logistic regression was performed for predictors of EI use.
RESULTS: From 332 ICA BCVI included, 21 (6.3%) underwent EI. 0/145 (0%) grade 1, 8/101 (7.9%) grade 2, 12/51 (23.5%) grade 3, and 1/20 (5.0%) grade 4 ICA BCVI underwent EI. Stroke occurred in 6/21 (28.6%) ICA BCVI undergoing EI and in 33/311 (10.6%) not undergoing EI (P = .03), with all strokes with EI use occurring prior to or at the same time as EI. Percentage of luminal stenosis (37.75 vs 20.29%, P = .01) and median pseudoaneurysm size (9.00 mm vs 3.00 mm, P = .01) were greater in ICA BCVI undergoing EI. On logistic regression, only pseudoaneurysm size was associated with EI (odds ratio 1.205, 95% CI 1.035-1.404, P = .02). Of the 8 grade 2 ICA BCVI undergoing EI, 3/8 were grade 2 and 5/8 were grade 3 prior to EI. Of the 12 grade 3 ICA BCVI undergoing EI, 11/12 were grade 3 and 1/12 was a grade 2 ICA BCVI prior to EI.
CONCLUSIONS: Pseudoaneurysm size is associated with use of EI for ICA BCVI. Stroke is more common in ICA BCVI with EI but did not occur after EI use.
METHODS: A post-hoc analysis of a prospective, observational study at 16 U.S. trauma centers from 2018 to 2020 was conducted. Internal carotid artery (ICA) BCVI was included. The primary outcome was EI use. Multivariable logistic regression was performed for predictors of EI use.
RESULTS: From 332 ICA BCVI included, 21 (6.3%) underwent EI. 0/145 (0%) grade 1, 8/101 (7.9%) grade 2, 12/51 (23.5%) grade 3, and 1/20 (5.0%) grade 4 ICA BCVI underwent EI. Stroke occurred in 6/21 (28.6%) ICA BCVI undergoing EI and in 33/311 (10.6%) not undergoing EI (P = .03), with all strokes with EI use occurring prior to or at the same time as EI. Percentage of luminal stenosis (37.75 vs 20.29%, P = .01) and median pseudoaneurysm size (9.00 mm vs 3.00 mm, P = .01) were greater in ICA BCVI undergoing EI. On logistic regression, only pseudoaneurysm size was associated with EI (odds ratio 1.205, 95% CI 1.035-1.404, P = .02). Of the 8 grade 2 ICA BCVI undergoing EI, 3/8 were grade 2 and 5/8 were grade 3 prior to EI. Of the 12 grade 3 ICA BCVI undergoing EI, 11/12 were grade 3 and 1/12 was a grade 2 ICA BCVI prior to EI.
CONCLUSIONS: Pseudoaneurysm size is associated with use of EI for ICA BCVI. Stroke is more common in ICA BCVI with EI but did not occur after EI use.
摘要：
背景：使用血管内介入（EI）治疗钝性脑血管损伤（BCVI）尚无共识指南。在全国范围内进行EI的BCVI的EI使用率和影像学特征尚不清楚。
方法：对前瞻性，我们于2018年至2020年在美国16个创伤中心进行了观察性研究.纳入颈内动脉（ICA）BCVI。主要结果是EI使用。对EI使用的预测因子进行多变量逻辑回归。
结果：包括332个ICABCVI，21人（6.3%）接受了EI。0/145（0％）1级，8/101（7.9％）2级，12/51（23.5％）3级和1/20（5.0％）4级ICABCVI接受EI。卒中发生在6/21(28.6%)ICABCVI接受EI和33/311(10.6%)未接受EI(P=0.03),所有使用EI的笔划在EI之前或与EI同时发生。管腔狭窄的百分比（37.75vs20.29%，P=0.01）和中位假性动脉瘤大小（9.00mmvs3.00mm，P=0.01）在接受EI的ICABCVI中更大。在逻辑回归中，只有假性动脉瘤大小与EI相关(比值比1.205,95%CI1.035-1.404,P=.02).在接受EI的8名2级ICABCVI中，在EI之前，3/8是2级，5/8是3级。在接受EI的12名3级ICABCVI中，11/12是3级，1/12是EI之前的2级ICABCVI。
结论：假性动脉瘤大小与ICABCVI使用EI相关。卒中在有EI的ICABCVI中更为常见，但在使用EI后未发生。
方法：对前瞻性，我们于2018年至2020年在美国16个创伤中心进行了观察性研究.纳入颈内动脉（ICA）BCVI。主要结果是EI使用。对EI使用的预测因子进行多变量逻辑回归。
结果：包括332个ICABCVI，21人（6.3%）接受了EI。0/145（0％）1级，8/101（7.9％）2级，12/51（23.5％）3级和1/20（5.0％）4级ICABCVI接受EI。卒中发生在6/21(28.6%)ICABCVI接受EI和33/311(10.6%)未接受EI(P=0.03),所有使用EI的笔划在EI之前或与EI同时发生。管腔狭窄的百分比（37.75vs20.29%，P=0.01）和中位假性动脉瘤大小（9.00mmvs3.00mm，P=0.01）在接受EI的ICABCVI中更大。在逻辑回归中，只有假性动脉瘤大小与EI相关(比值比1.205,95%CI1.035-1.404,P=.02).在接受EI的8名2级ICABCVI中，在EI之前，3/8是2级，5/8是3级。在接受EI的12名3级ICABCVI中，11/12是3级，1/12是EI之前的2级ICABCVI。
结论：假性动脉瘤大小与ICABCVI使用EI相关。卒中在有EI的ICABCVI中更为常见，但在使用EI后未发生。
