Clinical and radiographic outcomes following traumatic Grade 1 and 2 @entity1914 : a 10-year retrospective analysis from a Level I @entity130 center. The Parkland Carotid and XXXX .

@entity1 @entity64 @entity63 @entity117 @entity1317 @entity1281 @entity1914 @entity130 @entity385
UNASSIGNED: OBJECT Proper screening, management, and follow-up of Grade 1 and 2 blunt @entity1914 (BCIs) remains controversial. These low-grade BCIs were analyzed to define their natural history and establish a rational management plan based on lesion progression and @entity385 . METHODS A retrospective review of a prospectively maintained database of all blunt traumatic carotid and vertebral @entity1317 treated between August 2003 and April 2013 was performed and Grade 1 and 2 BCIs were identified. Grade 1 injuries are defined as a vessel lumen stenosis of less than 25%, and Grade 2 injuries are defined as a stenosis of the vessel lumen between 25% and 50%. Demographic information, radiographic imaging, number of imaging sessions performed per individual, length of radiographic follow-up, radiographic outcome at end of follow-up, treatment(s) provided, and documentation of @entity385 or transient @entity63 attack were recorded. RESULTS One hundred seventeen Grade 1 and 2 BCIs in 100 @entity1 were identified and available for follow-up. The mean follow-up duration was 60 days. Final imaging of Grade 1 and 2 BCIs demonstrated that 64% of cases had resolved, 13% of cases were radiographically stable, and 9% were improved, whereas 14% radiographically worsened. Of the treatments received, 54% of cases were treated with @entity117 ( @entity1281 ), 31% received no treatment, and 15% received various medications and treatments, including endovascular stenting. There was 1 @entity385 that was thought to be related to bilateral Grade 2 BCI, which developed soon after hospital admission. CONCLUSIONS The majority of Grade 1 and 2 BCIs remained stable or improved at final follow-up. Despite a 14% rate of radiographic worsening in the Grade 1 and 2 BCIs cohort, there were no adverse clinical outcomes associated with these radiographic changes. The @entity64 rate was 1% in this low-grade BCIs cohort, which may be an overestimate. The use of @entity1281 or other antiplatelet or anticoagulant medications in these low-grade BCIs did not appear to correlate with @entity130 stability, nor with a decreased rate of @entity385 . Although these data suggest that these Grade 1 and 2 BCIs may require less intensive radiographic follow-up, future prospective studies are needed to make conclusive changes related to treatment and management.
