{
  "abstract": "Background Injuries of the carotid and vertebral arteries are among the most technically daunting challenges in the management of a trauma patient, risking rapid hemodynamic collapse, cerebral hypoperfusion, and airway compromise. Endovascular reconstruction was performed using the GORE® VIABAHN® covered stent, whose heparin-bonded (CBAS®) ePTFE membrane provides an immediate seal while mitigating thrombogenicity, and whose nitinol framework ensures conformability to the mobile, tortuous cervical vasculature.Methods We included patients with complex extracranial carotid or vertebral artery injuries treated between January 2016 and December 2025 at St. Michael’s Hospital, Toronto, Ontario, Canada. Diagnosis was through preoperative CT angiography. Procedures were performed under general anesthesia and systemic heparinization. Technical success was defined as complete endovascular vessel reconstruction with preserved distal perfusion.Results After searching our institutional database, we were able to find four cases (mean age, 39 years; min-max, 31-53 years) of extracranial vertebral artery or carotid artery injury that utilized the Viabahn covered stent. Three of the injuries involved the carotid artery and one involved the vertebral artery. Three were traumatic and one was a post radiation therapy carotid blowout. Complete lesion exclusion with preserved antegrade flow was achieved in all four cases without intraoperative complications or embolic events. All patients remained neurologically stable or improved during follow-up.Conclusion Endovascular reconstruction with heparin-bonded covered stents was and safe and effective in our limited case series of injuries involving the extracranial carotid arteries and vertebral artery. This approach maintains continuous cerebral perfusion and provides immediate hemostasis.Keywords Carotid Blowout; Carotid Pseudoaneurysm; Vertebral Artery Trauma; Vascular Trauma; Covered Stents; GORE VIABAHN.Disclosures D. Sacdalan: None. J. Spears: None. T. Marotta: None. V. Pereira: None. H. Abualhasan: None.Abstract E-275 Figure 1(Traumatic Pseudoaneurysm and Carotid-Jugular Fistula) presented with high-flow venous washout that obscured the landing zone",
  "authors": [
    {
      "affiliations": [
        "Radiology, St. Michael’s Hospital, Toronto, ON, Canada"
      ],
      "name": "D Sacdalan"
    },
    {
      "affiliations": [
        "Neurosurgery, St. Michael’s Hospital, Toronto, ON, Canada"
      ],
      "name": "J Spears"
    },
    {
      "affiliations": [
        "University of Toronto, Toronto, ON, Canada"
      ],
      "name": "J Diestro"
    },
    {
      "affiliations": [
        "Radiology, St. Michael’s Hospital, Toronto, ON, Canada"
      ],
      "name": "T Marotta"
    },
    {
      "affiliations": [
        "Neurosurgery, St. Michael’s Hospital, Toronto, ON, Canada"
      ],
      "name": "V Pereira"
    },
    {
      "affiliations": [
        "Radiology, St. Michael’s Hospital, Toronto, ON, Canada"
      ],
      "name": "H Abualhasan"
    }
  ],
  "title": "E-275 Saving the brain’s lifelines: a case series of endovascular reconstruction of carotid and vertebral artery injuries with GORE® VIABAHN® covered stents",
  "uid": "bc952e79-12fb-5e50-92cd-72bec1af508b"
}