Successful Common Carotid Interposition Graft Using Proximal Saphenous Vein in a Patient with Cervical Gunshot Injuries: A Case Report

Gunshot injuries to the head and neck usually result in severe trauma due to damage to major vessels and pose challenging surgical management. A penetrating neck injury places numerous organs at a significant risk.

Presentation: 

We present a 39-year-old female transferred to the level I trauma center due to multiple pellet injuries to the neck and jaw.

Diagnosis:

 Computed tomography (CT) angiography showed the presence of multiple metal densities, an intimal flap, and a local thrombus in the left common carotid artery.

Intervention: 

The patient underwent surgical exploration, which revealed neck hematoma and near-total transection of the left common carotid artery. She received a carotid interposition graft (CIP) using the greater saphenous vein to reconstruct the artery.

Outcomes:

 Following an uneventful recovery, the patient was discharged three days after the surgery without any neurological side effects or hematoma. A follow-up CT angiography six weeks after the discharge showed a successful graft.

 This case presents a rare scenario of a penetrating neck injury with foreign objects in zone 2, necessitating a specialized surgical approach. Therefore, it contributes to the current literature and aids surgeons in managing similar patients.