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Bertellotti et al. Vessel Plus 2017;1:159-62 Vessel Plus
DOI: 10.20517/2574-1209.2017.10
www.vpjournal.net
Case Report Open Access

Stab wound with transection of left vertebral

artery at V3

Robert Bertellotti , Oluwaseye Ayoola Ogun , Angel Mironov , Juan Antonio Asensio 1
2
1
1
1 Department of Surgery, Division of Trauma Surgery and Surgical Critical Care, Creighton University School of Medicine, Omaha, NE 68131-2137, USA.
2 Department of Radiology, Creighton University School of Medicine, Omaha, NE 68131-2137, USA.
Correspondence to: Dr. Juan Antonio Asensio, Department of Surgery, Division of Trauma Surgery and Surgical Critical Care, Creighton University
School of Medicine, 601 North 30th Street, Suite 3701, Omaha, NE 68131-2137, USA. E-mail: JuanAsensio@creighton.edu

How to cite this article: Bertellotti R, Ogun OA, Mironov A, Asensio JA. Stab wound with transection of left vertebral artery at V3. Vessel Plus
2017;1:159-62.

Dr. Juan Antonio Asensio currently serves as Professor and Vice-Chairman of the Department of Surgery of
Creighton University (With Tenure). He has been tenured at four other universities. He is also the Chief of the
Division of Trauma Surgery and Surgical Care. He is the Director of the Trauma Center and Trauma Program
and Creighton University Hospital. He is the Professor of Clinical and Translational Science Creighton University
Medical School. He is also appointed as Professor of Surgery Adjunct, Uniform Services University of the Health
Sciences (USUHS), F. Edward Hebert School of Medicine, Bethesda, Maryland.

ABSTRACT
Article history: While vertebral artery injuries are uncommon, they can have significant morbidity if not
Received: 3 Apr 2017 identified and treated in a timely fashion. While the majority of vertebral artery injuries are
Accepted: 15 Jun 2017 the result of blunt injury and typically have favorable outcomes, a substantial percentage of
Published: 26 Sep 2017 patients with penetrating injury to the neck may also have vertebral artery injury necessitating
angiographic or operative intervention. A 45-year-old male sustained a single stab wound to
Key words: the apex of the posterior triangle of the neck, below the left mastoid process. At the scene,
Vertebral artery, Emergency Medical Services personnel reported large blood loss and upon arrival, his initial
stab wound, vital signs were consistent with Class II/III hemorrhagic shock. Physical examination revealed
vertebral artery injuries a 9 cm longitudinal and deep laceration which began to bleed rapidly and profusely during
his inital evaluation. The patient was intubated and rapidly transported to the operating room
for exploration of the wound with direct control of the suspected vascular injury via suture
ligation and application of vascular clips and to interventional radiology suite for embolization.
Operative control was necessary however, immediate post-operative angiography allowed
confirmation of collateral cerebral perfusion. The patient had an uneventful recovery and was
evaluated in the Trauma Clinic during his 7, 14, 30 and 60-day follow-up.

INTRODUCTION therefore, it is rarely injured. An epidemiology study
by Hsu et al. identified 14 cases, 0.08% of vertebral
[1]
The vertebral artery is located deep within the neck artery injuries in a multi-institutional database of

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