Menu
Medical Condition
Vascular Surgery
Vascular Surgery ICD-10: S15.0

Vascular Injury from Blunt Trauma (Carotid)

Intimal tear or pseudoaneurysm of the carotid artery due to blunt force trauma to the neck.

Medical Disclaimer
This condition guide is intended for educational and informational purposes only. It does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider regarding any symptoms or medical conditions.

Clinical Assessment & Protocol

Typical Presentation (HPI)

EN: Patient reports neck pain and localized swelling following a motor vehicle accident. AR: المريض يشكو من ألم في الرقبة وتورم موضعي بعد حادث سيارة.

General Examination

EN: Neck tenderness, possible bruit, and neurological deficits. AR: إيلام في الرقبة، لغط محتمل، وعجز عصبي.

Treatment Protocol

EN: Antiplatelet therapy or endovascular stenting depending on grade. AR: علاج مضاد للصفيحات أو وضع دعامة تداخلية حسب الدرجة.

Patient Education

EN: Watch for neurological symptoms and attend regular follow-up. AR: مراقبة الأعراض العصبية والالتزام بالمتابعة الدورية.

Systemic & Specialized Examinations

Cardiovascular

EN: S1, S2 present. No murmurs. AR: صوتا القلب الأول والثاني طبيعيان. لا توجد نفخات.

Respiratory

EN: Lungs clear to auscultation. AR: الرئتان صافيتان عند التسمع.

Gastrointestinal

EN: Abdomen soft, non-tender. AR: البطن لين ولا يوجد ألم.

Neurological

EN: Alert, oriented x3. No focal deficits. AR: المريض واعي ومدرك. لا يوجد عجز عصبي بؤري.

Dermatological

EN: Unremarkable or not routinely indicated. AR: طبيعي أو غير مطلوب روتينياً.

Psychiatric

EN: Unremarkable or not routinely indicated. AR: طبيعي أو غير مطلوب روتينياً.

OB/GYN

EN: Unremarkable or not routinely indicated. AR: طبيعي أو غير مطلوب روتينياً.

Ophthalmic

EN: Unremarkable or not routinely indicated. AR: طبيعي أو غير مطلوب روتينياً.

Dental

EN: Unremarkable or not routinely indicated. AR: طبيعي أو غير مطلوب روتينياً.

Orthopedic & Trauma Assessments

Range of Motion

EN: Unremarkable or not routinely indicated. AR: طبيعي أو غير مطلوب روتينياً.

Local Examination

EN: Unremarkable or not routinely indicated. AR: طبيعي أو غير مطلوب روتينياً.

Clinical Guide: Blunt Cerebrovascular Injury (BCVI) of the Carotid Artery

1. Comprehensive Introduction & Overview

Blunt Cerebrovascular Injury (BCVI) involving the carotid artery represents one of the most challenging and high-stakes diagnoses in trauma medicine. Often referred to as a "hidden killer," BCVI occurs when a blunt force trauma—typically from motor vehicle accidents, falls, or assaults—causes damage to the internal carotid artery (ICA) or vertebral artery.

Unlike penetrating trauma, where the injury is immediately obvious, blunt trauma to the neck can cause subtle intimal tears, dissections, or pseudoaneurysms that may remain asymptomatic for hours or even days. This "latent period" is the primary clinical trap; patients may appear neurologically intact upon initial assessment, only to suffer a catastrophic thromboembolic stroke once the intimal flap propagates or a thrombus dislodges.

As a clinician, maintaining a high index of suspicion is the cornerstone of management. Early identification allows for the initiation of antithrombotic therapy, which remains the gold standard for preventing secondary neurological deficits.


2. Deep-Dive: Pathophysiology and Mechanisms

The pathophysiology of BCVI is rooted in the unique anatomical position of the carotid arteries as they traverse the cervical spine and the base of the skull.

Mechanisms of Injury

  • Hyperextension and Lateral Flexion: Sudden, violent movement of the neck can stretch the ICA over the transverse processes of the upper cervical vertebrae (C1-C3), leading to intimal tearing.
  • Direct Impact: A direct blow to the neck (e.g., "clothesline" injuries or steering wheel contact) can crush the artery against the underlying bony structures.
  • Skull Base Fractures: Fractures extending into the carotid canal often involve shearing forces that lacerate or dissect the carotid artery.
  • Intraoral Trauma: Penetrating trauma to the soft palate (e.g., falling with a pencil in the mouth) can cause indirect blunt injury to the ICA.

Histopathological Progression

  1. Intimal Disruption: The initial mechanical force causes a tear in the tunica intima.
  2. Subintimal Hematoma: Blood tracks into the arterial wall, creating a flap that narrows the lumen.
  3. Thrombus Formation: The exposed subendothelial collagen triggers platelet aggregation, leading to a mural thrombus.
  4. Embolization: The thrombus fragments and travels distally to the intracranial circulation, resulting in ischemic stroke.

3. Clinical Staging and Grading (The Denver/Biffl Criteria)

To standardize management and prognosis, the Denver Criteria (Biffl Scale) is universally utilized to classify the severity of BCVI.

Grade Description
Grade I Irregularity of the vessel wall or dissection with <25% luminal narrowing.
Grade II Dissection or intramural hematoma with ≥25% luminal narrowing, intimal flap, or visible thrombus.
Grade III Pseudoaneurysm.
Grade IV Occlusion.
Grade V Transection with free extravasation.

4. Clinical Indications and Diagnostic Protocol

The Screening Dilemma

Because BCVI is often asymptomatic, screening is mandatory for high-risk trauma patients. The Expanded Denver Screening Criteria includes:

  • Signs/Symptoms: Arterial hemorrhage from neck/mouth, cervical bruit, expanding neck hematoma, focal neurological deficit, or unexplained Horner’s syndrome.
  • Mechanism/Fracture Patterns:
    • Le Fort II or III fractures.
    • Skull base fractures involving the carotid canal.
    • Cervical spine fractures (especially subluxation or fractures involving the transverse foramen).
    • Near-hanging with anoxic brain injury.
    • Seat-belt injuries with neck ecchymosis.

Diagnostic Tests

  1. CT Angiography (CTA): The gold standard for initial diagnosis. High sensitivity (95%+) and specificity.
  2. Digital Subtraction Angiography (DSA): The "gold standard" for anatomy but invasive. Reserved for cases where CTA is equivocal or when endovascular intervention is planned.
  3. MRA/MRI: Less common in the acute trauma bay due to time constraints and patient monitoring difficulties, though excellent for evaluating the extent of ischemic penumbra.

5. Differential Diagnosis

When a patient presents with neurological symptoms following trauma, the following must be considered:
* Traumatic Brain Injury (TBI): Intracranial hemorrhage or diffuse axonal injury.
* Carotid-Cavernous Fistula: Often presents with pulsatile proptosis and chemosis.
* Vertebral Artery Injury: Often masked by or co-occurring with carotid injury.
* Fat Embolism Syndrome: Usually associated with long-bone fractures.
* Spinal Cord Injury: Should be ruled out if quadriplegia or sensory levels are present.


6. Risks, Side Effects, and Management

Pharmacological Management

The mainstay of treatment is antiplatelet or anticoagulant therapy.
* Antiplatelets: Aspirin or Clopidogrel are typically used for Grades I and II to prevent secondary thrombus formation.
* Anticoagulants: Heparin (IV infusion) is often preferred for more severe grades, provided there are no contraindications (e.g., active intracranial hemorrhage).

Endovascular Intervention

Stenting is indicated for pseudoaneurysms (Grade III) or cases where medical management fails to prevent distal embolization. Surgery is rarely performed due to the high mortality associated with exposing the carotid artery in an acute trauma field.

Contraindications

  • Active Intracranial Hemorrhage: Absolute contraindication to full anticoagulation.
  • Coagulopathy: Must be corrected prior to surgical or invasive endovascular procedures.
  • Severe Multiorgan Failure: May necessitate a watch-and-wait approach over aggressive intervention.

7. Long-Term Prognosis

The prognosis for BCVI is highly dependent on the timing of diagnosis and the presence of neurological deficits at the time of presentation.
* Asymptomatic Patients: With early identification and therapeutic anticoagulation, the risk of stroke is significantly reduced.
* Symptomatic Patients: If a stroke has already occurred, the prognosis is guarded. Long-term rehabilitation is often necessary.
* Follow-up: Repeat imaging (CTA) is typically performed at 7–10 days post-injury to ensure the lesion has stabilized or resolved.


8. Frequently Asked Questions (FAQ)

1. What is the most common symptom of a carotid artery injury?

Often, there are no symptoms. If present, they may include neck pain, headache, or focal neurological signs like hemiparesis or visual changes (amaurosis fugax).

2. Why is a "clothesline injury" so dangerous?

It causes rapid hyperextension of the neck, which stretches the carotid artery over the cervical spine, leading to shearing forces that tear the arterial intima.

3. Does every patient with a neck injury need a CTA?

No. Screening is directed by the Denver Criteria. If a patient meets the clinical or anatomical criteria, a CTA is mandatory.

4. What is the risk of stroke if BCVI is left untreated?

Without treatment, the stroke rate for Grade II–IV injuries can be as high as 40–50%.

5. How long should a patient remain on anticoagulation?

Typically, 3 to 6 months is the standard duration, followed by repeat imaging to confirm healing.

6. Can I use MRI instead of a CT scan for initial screening?

No. CT angiography is significantly faster, more accessible, and more sensitive for acute vascular trauma in the trauma bay.

7. What if the patient has a brain bleed? Can I still treat the carotid injury?

This is a complex clinical decision. Usually, the brain bleed takes precedence, and anticoagulation is deferred or managed with antiplatelets only after the intracranial condition stabilizes.

8. What is the role of the "Carotid Canal" in these injuries?

Fractures involving the carotid canal are highly specific for carotid artery injury; the artery is fixed within the canal and cannot move, making it susceptible to shearing if the skull base is fractured.

9. Is surgery the first-line treatment?

No. Open surgery is rarely indicated due to high risks. Endovascular stenting is the preferred procedural intervention if medical management fails.

10. Can a carotid injury present days later?

Yes. The "latent period" can last up to 72 hours, which is why patients meeting criteria are often admitted for observation even if the initial scan is negative or the patient is asymptomatic.


9. Clinical Summary Table: Management Strategy

Grade Primary Treatment Follow-up
Grade I Aspirin CTA at 7 days
Grade II Aspirin or Heparin CTA at 7-10 days
Grade III Stenting or Aggressive Anticoagulation CTA at 1 month
Grade IV Medical/Anticoagulation (if patent) CTA at 1 month
Grade V Surgical/Endovascular Repair Long-term surveillance

Disclaimer: This guide is for educational purposes for healthcare professionals. Clinical decisions should always be based on institutional protocols and individual patient assessment.

Treatment & Management Options

Supportive Devices / Braces

Achilles Tendon Heel Wedges (Stackable)
Mobility Assets (Chairs, Crutches)
Active Cryotherapy & Compression Unit (Game Ready / IceMan)
Mobility Assets (Chairs, Crutches)
Agility Training & Plyometric Box Set
Mobility Assets (Chairs, Crutches)
Ankle Weight Cuffs (Set)
Mobility Assets (Chairs, Crutches)
Axillary (Underarm) Crutches
Mobility Assets (Chairs, Crutches)
Axillary Crutches (Aluminum)
Mobility Assets (Chairs, Crutches)
Blood Flow Restriction (BFR) Training Cuffs
Mobility Assets (Chairs, Crutches)
CAM Walker Boot (Walking Boot)
Mobility Assets (Chairs, Crutches)
Custom Lightweight Wheelchair
Mobility Assets (Chairs, Crutches)
Ergonomic Heated Dialysis Treatment Chair
Mobility Assets (Chairs, Crutches)
Foam Roller (High Density)
Mobility Assets (Chairs, Crutches)
Forearm (Lofstrand) Crutches
Mobility Assets (Chairs, Crutches)
Front-Wheeled Walker (Rollator)
Mobility Assets (Chairs, Crutches)
Goniometer (Stainless Steel)
Mobility Assets (Chairs, Crutches)
Hand Therapy Putty Kit
Mobility Assets (Chairs, Crutches)
Hand-Held Muscle Dynamometer
Mobility Assets (Chairs, Crutches)
Knee CPM (Continuous Passive Motion) Machine
Mobility Assets (Chairs, Crutches)
Knee Scooter (Knee Walker)
Mobility Assets (Chairs, Crutches)
Parallel Bars (Gait Training)
Mobility Assets (Chairs, Crutches)
Pediatric Hip Spica Cast Protector
Mobility Assets (Chairs, Crutches)
Physio Ball (Swiss Ball)
Mobility Assets (Chairs, Crutches)
Pneumatic Compression Therapy System (Leg)
Mobility Assets (Chairs, Crutches)
Scrotal Support (Jockstrap / Suspensory)
Mobility Assets (Chairs, Crutches)
Sequential Compression Devices (SCDs)
Mobility Assets (Chairs, Crutches)
Shoulder CPM Machine
Mobility Assets (Chairs, Crutches)
Standard Folding Walker (4-Point)
Mobility Assets (Chairs, Crutches)
Theraband Resistance Exercise Bands
Mobility Assets (Chairs, Crutches)
Ambulatory BP Monitor (24h)
Diagnostic / Monitoring Support
Ambulatory Blood Pressure Monitor (24h ABPM)
Diagnostic / Monitoring Support
Ambulatory Blood Pressure Monitor (ABPM)
Diagnostic / Monitoring Support
Automated External Defibrillator
Diagnostic / Monitoring Support
Automated External Defibrillator (AED)
Diagnostic / Monitoring Support
Bioimpedance Spectroscopy Body Composition Monitor (BCM)
Diagnostic / Monitoring Support
Blake Drain (Silicone Fluted)
Diagnostic / Monitoring Support
CardioMEMS HF Sensor
Diagnostic / Monitoring Support
CardioMEMS HF System
Diagnostic / Monitoring Support
Continuous Glucose Monitor
Diagnostic / Monitoring Support
Continuous Glucose Monitor (CGM) - e.g. Freestyle Libre
Diagnostic / Monitoring Support
Electronic Fetal Monitor (CTG Machine)
Diagnostic / Monitoring Support
End-Tidal CO2 Monitor (Capnograph)
Diagnostic / Monitoring Support
Event Monitor (30 Days)
Diagnostic / Monitoring Support
Event Monitor (Symptom Activated)
Diagnostic / Monitoring Support
External Loop Recorder (ELR)
Diagnostic / Monitoring Support
Eyegaze Communication Device
Diagnostic / Monitoring Support
HeartLogic (Bardy Diagnostics)
Diagnostic / Monitoring Support
Hemodialysis Machine (Clinical Use)
Diagnostic / Monitoring Support
Holter Monitor (14 Days)
Diagnostic / Monitoring Support
Holter Monitor (24 Hours)
Diagnostic / Monitoring Support
Holter Monitor (48 Hours)
Diagnostic / Monitoring Support
Holter Monitor (7 Days)
Diagnostic / Monitoring Support
Holter Monitor (72 Hours)
Diagnostic / Monitoring Support
Home BP Monitor (Upper Arm)
Diagnostic / Monitoring Support
Home BP Monitor (Wrist)
Diagnostic / Monitoring Support
Home Blood Pressure Monitor (Upper Arm)
Diagnostic / Monitoring Support
Home INR Monitor (CoaguChek)
Diagnostic / Monitoring Support
Home INR Monitor (Roche)
Diagnostic / Monitoring Support
ILR - Biomonitor III
Diagnostic / Monitoring Support
Implantable Loop Recorder
Diagnostic / Monitoring Support
Implantable Loop Recorder (ILR) - Confirm Rx
Diagnostic / Monitoring Support
Implantable Loop Recorder (ILR) - Reveal LINQ
Diagnostic / Monitoring Support
Jackson-Pratt (JP) Drain (10 Fr / 19 Fr)
Diagnostic / Monitoring Support
LifeVest
Diagnostic / Monitoring Support
Loop Event Monitor (Auto-Trigger)
Diagnostic / Monitoring Support
Low Vision Magnifier / Closed Circuit TV (CCTV)
Diagnostic / Monitoring Support
Manual Defibrillator (Philips HeartStart XL)
Diagnostic / Monitoring Support
Manual External Defibrillator (Zoll R Series)
Diagnostic / Monitoring Support
Mobile Cardiac Telemetry
Diagnostic / Monitoring Support
Mobile Cardiac Telemetry (MCT)
Diagnostic / Monitoring Support
Nephrostomy Drainage Bag
Diagnostic / Monitoring Support
Non-invasive Ultrasonic Transit-Time Flowmeter
Diagnostic / Monitoring Support
Overnight Pulse Oximeter (Wrist/Ring)
Diagnostic / Monitoring Support
Patch Monitor (Zio Patch)
Diagnostic / Monitoring Support
Rectal Balloon Catheter (for UDS)
Diagnostic / Monitoring Support
Remote Patient Monitoring (RPM) Kit
Diagnostic / Monitoring Support
Remote Patient Monitoring Kit
Diagnostic / Monitoring Support
Smart Scale (With Body Comp)
Diagnostic / Monitoring Support
Smart Scale (With Body Composition)
Diagnostic / Monitoring Support
Smartwatch ECG (Apple Watch/KardiaBand)
Diagnostic / Monitoring Support
TENS Unit (Transcutaneous Electrical Nerve Stimulator)
Diagnostic / Monitoring Support
Urine Drainage Bag (2000 mL - Bedside)
Diagnostic / Monitoring Support
Urine Leg Bag (500 mL)
Diagnostic / Monitoring Support
Urine Leg Bag (750 mL)
Diagnostic / Monitoring Support
Urodynamics Catheter (Dual-Lumen)
Diagnostic / Monitoring Support
Urometer Drainage Bag
Diagnostic / Monitoring Support
VitalPatch (Continuous Vital Signs Monitor)
Diagnostic / Monitoring Support
Wearable Cardioverter Defibrillator
Diagnostic / Monitoring Support
Wearable Cardioverter Defibrillator (LifeVest)
Diagnostic / Monitoring Support
Wearable ECG (Kardia Mobile)
Diagnostic / Monitoring Support
Zoll LifeVest 4000
Diagnostic / Monitoring Support
Abdominal Binder (Elastic)
Prosthetic & Orthotic Devices
Abdominal Binder / Maternity Support Belt
Prosthetic & Orthotic Devices
Airplane Splint
Prosthetic & Orthotic Devices
Aluminum Frog/Toad Finger Splint
Prosthetic & Orthotic Devices
Ankle Stirrup Brace
Prosthetic & Orthotic Devices
Ankle-Foot Orthosis (AFO) - Articulated
Prosthetic & Orthotic Devices
Ankle-Foot Orthosis (AFO) - Solid
Prosthetic & Orthotic Devices
Arizona AFO (Custom Gauntlet)
Prosthetic & Orthotic Devices
Artificial Urinary Sphincter (AUS)
Prosthetic & Orthotic Devices
Aspen Cervical Collar (2-Post)
Prosthetic & Orthotic Devices
Bandage Contact Lens
Prosthetic & Orthotic Devices
Boston Brace (Scoliosis)
Prosthetic & Orthotic Devices
Buddy Taping Finger Wrap
Prosthetic & Orthotic Devices
Böhler Traction Bow
Prosthetic & Orthotic Devices
CROW Boot (Charcot Restraint Orthotic Walker)
Prosthetic & Orthotic Devices
Carbon Fiber Morton's Extension Insole
Prosthetic & Orthotic Devices
Cervical Collar (Aspen Vista)
Prosthetic & Orthotic Devices
Chest Binder Modle A-15
Prosthetic & Orthotic Devices
CircAid (Adjustable Compression Device)
Prosthetic & Orthotic Devices
Clear Protective Eye Shield (Fox Shield)
Prosthetic & Orthotic Devices
Colostomy / Ileostomy Pouch System (2-Piece)
Prosthetic & Orthotic Devices
Compression Garments (Custom-Fit)
Prosthetic & Orthotic Devices
Contoured Back Support Model A-02
Prosthetic & Orthotic Devices
Cranial Helmet
Prosthetic & Orthotic Devices
Custom ACL Functional Derotation Brace
Prosthetic & Orthotic Devices
Diabetic Extra-Depth Shoe
Prosthetic & Orthotic Devices
Dynamic Soft Drop Foot Orthosis (Dictus Band)
Prosthetic & Orthotic Devices
Elastic Bandage (Ace Wrap)
Prosthetic & Orthotic Devices
Elbow Immobilizer (Post-Op Splint)
Prosthetic & Orthotic Devices
Female Mid-Urethral Sling (TOT)
Prosthetic & Orthotic Devices
Female Mid-Urethral Sling (TVT)
Prosthetic & Orthotic Devices
Female Single-Incision Mini-Sling
Prosthetic & Orthotic Devices
Fiberglass Casting Tape
Prosthetic & Orthotic Devices
Figure-of-Eight Clavicle Splint
Prosthetic & Orthotic Devices
Forefoot Offloading Shoe (Wedge Shoe)
Prosthetic & Orthotic Devices
Functional Shoulder Stabilizer Brace (Sulley Brace)
Prosthetic & Orthotic Devices
Gradient Compression Stockings
Prosthetic & Orthotic Devices
Gradient Compression Stockings (20-30 mmHg)
Prosthetic & Orthotic Devices
Gradient Compression Stockings (30-40 mmHg)
Prosthetic & Orthotic Devices
Gradient Compression Stockings (40-50 mmHg)
Prosthetic & Orthotic Devices
Hallux Valgus Splint (Night-time)
Prosthetic & Orthotic Devices
Halo Vest Immobilizer System
Prosthetic & Orthotic Devices
Heel Offloading Shoe
Prosthetic & Orthotic Devices
Hinged Ankle Brace (Active Ankle T2)
Prosthetic & Orthotic Devices
Hinged Elbow Brace (ROM)
Prosthetic & Orthotic Devices
Hinged Knee Brace (ROM Adjustable)
Prosthetic & Orthotic Devices
Hip-Knee-Ankle-Foot Orthosis (HKAFO)
Prosthetic & Orthotic Devices
Insulin Pump (Subcutaneous)
Prosthetic & Orthotic Devices
Intermittent Pneumatic Compression (IPC) - Home
Prosthetic & Orthotic Devices
Jewett Hyperextension Brace
Prosthetic & Orthotic Devices
Knee Immobilizer (Zimmer Splint)
Prosthetic & Orthotic Devices
Kyphosis Posture Corrective Brace
Prosthetic & Orthotic Devices
Lace-Up Ankle Brace (ASO Style)
Prosthetic & Orthotic Devices
Lumbosacral Orthosis (LSO) Corset
Prosthetic & Orthotic Devices
Lymphedema Pump (Flexitouch)
Prosthetic & Orthotic Devices
Male Incontinence Clamp (Cunningham)
Prosthetic & Orthotic Devices
Male Urethral Sling (Advance/Virtue)
Prosthetic & Orthotic Devices
Mallet Finger Splint (Stack Splint)
Prosthetic & Orthotic Devices
Maxillomandibular Fixation (MMF) Arch Bars
Prosthetic & Orthotic Devices
Metatarsal Dome Pads
Prosthetic & Orthotic Devices
Miami J Cervical Collar
Prosthetic & Orthotic Devices
Microprocessor Knee (e.g., C-Leg)
Prosthetic & Orthotic Devices
Milwaukee Brace
Prosthetic & Orthotic Devices
Myoelectric Prosthetic Hand
Prosthetic & Orthotic Devices
Orthodontic Brackets and Archwires
Prosthetic & Orthotic Devices
Oval-8 Finger Splint (PIP/DIP)
Prosthetic & Orthotic Devices
Palatal Expander
Prosthetic & Orthotic Devices
Patellar Tendon Bearing (PTB) Brace
Prosthetic & Orthotic Devices
Patellar Tendon Strap (Chopat Strap)
Prosthetic & Orthotic Devices
Patellofemoral Tracking Brace (J-Bar)
Prosthetic & Orthotic Devices
Pavlik Harness
Prosthetic & Orthotic Devices
Pediatric Knee Ankle Foot Orthosis (KAFO)
Prosthetic & Orthotic Devices
Pediatric Spica Cast / Pavlik Harness
Prosthetic & Orthotic Devices
Pelvic Floor Stimulator Device
Prosthetic & Orthotic Devices
Penile Prosthesis (Inflatable 2-Piece System)
Prosthetic & Orthotic Devices
Penile Prosthesis (Inflatable 3-Piece System)
Prosthetic & Orthotic Devices
Penile Prosthesis (Malleable / Semi-Rigid)
Prosthetic & Orthotic Devices
Penile Traction Device (e.g., RestoreX)
Prosthetic & Orthotic Devices
Philadelphia Cervical Collar
Prosthetic & Orthotic Devices
Plantar Fasciitis Night Splint
Prosthetic & Orthotic Devices
Plaster of Paris (POP) Rolls
Prosthetic & Orthotic Devices
Pneumatic Compression - Venodyne
Prosthetic & Orthotic Devices
Pneumatic Compression Device
Prosthetic & Orthotic Devices
Pneumatic Compression Device (Sequential)
Prosthetic & Orthotic Devices
Pneumatic Compression Lymph Sleeve
Prosthetic & Orthotic Devices
Ponseti AFO with Denis Browne Bar
Prosthetic & Orthotic Devices
Post-Op Shoe (Rocker Bottom)
Prosthetic & Orthotic Devices
Post-Operative ROM Knee Brace
Prosthetic & Orthotic Devices
Prophylactic Knee Brace
Prosthetic & Orthotic Devices
Radial Gutter Splint
Prosthetic & Orthotic Devices
Rhino Cruiser (Hip Abduction Brace)
Prosthetic & Orthotic Devices
Rigid Carbon Fiber AFO
Prosthetic & Orthotic Devices
Rigid Gas Permeable (RGP) / Scleral Lens
Prosthetic & Orthotic Devices
SOMI Brace (Sternal Occipital Mandibular Immobilizer)
Prosthetic & Orthotic Devices
Sarmiento Brace (Humeral Fracture)
Prosthetic & Orthotic Devices
Self-Adherent Cohesive Wrap (Coban)
Prosthetic & Orthotic Devices
Shoulder Immobilizer / Sling
Prosthetic & Orthotic Devices
Shoulder Immobilizer with Abduction Pillow
Prosthetic & Orthotic Devices
Silicone Heel Cups
Prosthetic & Orthotic Devices
Silicone Toe Spacers / Separators
Prosthetic & Orthotic Devices
Simple Shoulder Sling (UltraSling)
Prosthetic & Orthotic Devices
Soft Foam Cervical Collar
Prosthetic & Orthotic Devices
Solid Ankle Cushion Heel (SACH) Foot
Prosthetic & Orthotic Devices
Sugar Tong Splint
Prosthetic & Orthotic Devices
Supramalleolar Orthosis (SMO)
Prosthetic & Orthotic Devices
TLSO Brace (Thoracolumbosacral Orthosis)
Prosthetic & Orthotic Devices
TMJ Occlusal Splint (Night Guard)
Prosthetic & Orthotic Devices
Tall Pneumatic CAM Walker Boot
Prosthetic & Orthotic Devices
Taylor's Brace D.L.S.O Long Model A-04
Prosthetic & Orthotic Devices
Testicular Prosthesis (Saline-Filled)
Prosthetic & Orthotic Devices
Testicular Prosthesis (Solid Silicone)
Prosthetic & Orthotic Devices
Thermoplastic Splint (Custom Hand Splint)
Prosthetic & Orthotic Devices
Thomas Splint with Pearson Attachment
Prosthetic & Orthotic Devices
Thumb Spica Splint
Prosthetic & Orthotic Devices
Tubular Stockinette
Prosthetic & Orthotic Devices
UCBL Orthosis
Prosthetic & Orthotic Devices
UM Frog Splint Modle E-03
Prosthetic & Orthotic Devices
UM Ankle Brace Lace Up Modle D-10
Prosthetic & Orthotic Devices
UM Anklet Comfort 2N (1 Pair) Modle D-13
Prosthetic & Orthotic Devices
UM Arm Sling Baggy Modle C-08
Prosthetic & Orthotic Devices
UM Cervical Collar Boneless Modle B-01
Prosthetic & Orthotic Devices
UM Cervical Pillow MODLE B-06
Prosthetic & Orthotic Devices
UM Cervical Soft Collar W/support Modle B-02
Prosthetic & Orthotic Devices
UM Clavicle Brace W/velcro Modle C-04
Prosthetic & Orthotic Devices
UM Elbow Support With Strap Comfort G-11
Prosthetic & Orthotic Devices
UM Finger Cot Splint Modle E-01
Prosthetic & Orthotic Devices
UM Foot Drop SplintModle D-07
Prosthetic & Orthotic Devices
UM Hallux Valgus Splint Modle D-12
Prosthetic & Orthotic Devices
UM Hand And Finger Splint Modle G-19
Prosthetic & Orthotic Devices
UM Knee Hinge Stabilizer Neoprene Modle F-12
Prosthetic & Orthotic Devices
UM Knee Immobilizer Long Type 19 Modle F-04
Prosthetic & Orthotic Devices
UM Knee Support Modle F-20
Prosthetic & Orthotic Devices
UM Knee Support Open Patella With Silicone Modle F-10
Prosthetic & Orthotic Devices
UM P.F Night Splint (De- Rotation Modle D-08
Prosthetic & Orthotic Devices
UM Pelvic Binder Modle A-24
Prosthetic & Orthotic Devices
UM Posture Brace Modle C-15
Prosthetic & Orthotic Devices
UM Rehab Silicone Heel Cups Modle I-01 / I-11
Prosthetic & Orthotic Devices
UM Rehab Silicone Insole With Medial Arch For Flat Foot Modle I-05
Prosthetic & Orthotic Devices
UM Rom Knee Brace Adjuster Telescope Modle F-11
Prosthetic & Orthotic Devices
UM Silicone Elastomer Insoles Modle I-02
Prosthetic & Orthotic Devices
UM Spondylsis Collar Philadelphia MODLE B-04
Prosthetic & Orthotic Devices
UM Static Cockup Splint Modle G-13
Prosthetic & Orthotic Devices
UM Tennis Elbow Support Wrap Round Modle G-09
Prosthetic & Orthotic Devices
UM Thumb Spica Modle G-07
Prosthetic & Orthotic Devices
UM Type 14" Knee Immobilizer Short Modle F-05
Prosthetic & Orthotic Devices
UM Wrist & Forearm Brace Modle G-23
Prosthetic & Orthotic Devices
UM Wrist & Forearm Brace Short Modle G-01
Prosthetic & Orthotic Devices
UM Wrist & Forearm With Thumb Stabilizer Modle G-08
Prosthetic & Orthotic Devices
UM Wrist & Thumb Support (Elastic) Modle G-04
Prosthetic & Orthotic Devices
Ulnar Collateral Ligament (UCL) Elbow Brace
Prosthetic & Orthotic Devices
Ulnar Gutter Splint
Prosthetic & Orthotic Devices
Um Plantar fasciitis Sleep Support Modle D-09
Prosthetic & Orthotic Devices
Undercast Cotton Padding (Webril)
Prosthetic & Orthotic Devices
Unloader Knee Brace (Osteoarthritis)
Prosthetic & Orthotic Devices
Vacuum Erection Device (VED)
Prosthetic & Orthotic Devices
Vaginal Pessary (Ring / Gellhorn)
Prosthetic & Orthotic Devices
Vascular Access Shielding Sleeve
Prosthetic & Orthotic Devices
Venous Foot Pump
Prosthetic & Orthotic Devices
Volar Cock-Up Wrist Splint
Prosthetic & Orthotic Devices
Wrist Drop Splint (Dynamic MCP Extension)
Prosthetic & Orthotic Devices
Wrist Splint (Cock-up)
Prosthetic & Orthotic Devices
Wrist Thumb Brace (Short Opponens)
Prosthetic & Orthotic Devices
coccyx cushion for tailbone pain
Prosthetic & Orthotic Devices
100% Silicone Foley Catheter (14F-24F)
General Medical Gear
3-Way Foley Catheter (22F/24F)
General Medical Gear
Automated Peritoneal Dialysis (APD) Cycler
General Medical Gear
Blood Glucose Monitor
General Medical Gear
Blood Pressure Cuff
General Medical Gear
Blood pressure monitor
General Medical Gear
Cardiac Monitor
General Medical Gear
Central Venous Catheter
General Medical Gear
Clean Intermittent Catheter (CIC) - Hydrophilic
General Medical Gear
Clean Intermittent Catheter (CIC) - Standard
General Medical Gear
Condom Catheter (Texas Catheter)
General Medical Gear
Continuous Bladder Irrigation (CBI) Set
General Medical Gear
Continuous Glucose Monitor (CGM)
General Medical Gear
Continuous Hemodialysis Machine Console (In-Center)
General Medical Gear
Continuous Renal Replacement Therapy (CRRT) Machine
General Medical Gear
Coude Tip Foley Catheter
General Medical Gear
Dialysate Solution Warmer Bag
General Medical Gear
Dialysis Access Device
General Medical Gear
Dialysis Machine (for advanced stages)
General Medical Gear
Dialysis Solution Bags
General Medical Gear
Dialysis machine
General Medical Gear
Doppler Ultrasound Device
General Medical Gear
ECG Machine
General Medical Gear
Electrolyte analyzer
General Medical Gear
Foley catheter
General Medical Gear
Hemodialysis Catheter
General Medical Gear
Hemodialysis Machine
General Medical Gear
Hospital-Grade Electric Breast Pump
General Medical Gear
IV Pole
General Medical Gear
Intensive Phototherapy Bank (Bili Lights)
General Medical Gear
Intravenous Catheter
General Medical Gear
Intravenous infusion pump
General Medical Gear
Irrigation Fluid Bags (Glycine 1.5% - 3000mL)
General Medical Gear
Irrigation Fluid Bags (Normal Saline 0.9% - 3000mL)
General Medical Gear
Latex Foley Catheter (12F-24F)
General Medical Gear
Mechanical Ventilator
General Medical Gear
Nasogastric (NG) Tube (Salem Sump)
General Medical Gear
Negative Pressure Wound Therapy (Wound VAC)
General Medical Gear
Neonatal Incubator (Isolette)
General Medical Gear
Osgood Schlatter Knee Brace
General Medical Gear
Oxygen Concentrator
General Medical Gear
Penrose Drain
General Medical Gear
Peritoneal Dialysis Catheter
General Medical Gear
Portable Reverse Osmosis (RO) Water Purification System
General Medical Gear
Scale
General Medical Gear
Sterile Dressings
General Medical Gear
Stoma Powder & Barrier Paste
General Medical Gear
Swan-Ganz Catheter
General Medical Gear
Syringes
General Medical Gear
T-Tube (Biliary)
General Medical Gear
UM Spinotech Taylor's Brace Modle A-16
General Medical Gear
Urinary Catheter
General Medical Gear
Urine Specimen Container (Sterile)
General Medical Gear
Vascular access device (e.g., central venous catheter)
General Medical Gear
ankle strapp
General Medical Gear
coccyx cushion
General Medical Gear
coccyx_ cushion for tailbone pain
General Medical Gear
foot insole for shortening
General Medical Gear
pH meter
General Medical Gear
Adaptive Servo-Ventilation (ASV)
Ventilation / CPAP Systems
Adaptive Servo-Ventilation (ASV) Machine
Ventilation / CPAP Systems
Auto-CPAP (APAP)
Ventilation / CPAP Systems
Auto-CPAP (APAP) Machine
Ventilation / CPAP Systems
Avea Ventilator (ICU)
Ventilation / CPAP Systems
Bi-Level Positive Airway Pressure (BiPAP)
Ventilation / CPAP Systems
BiPAP (Bilevel Positive Airway Pressure) Machine
Ventilation / CPAP Systems
BiPAP - ST (Spontaneous/Timed)
Ventilation / CPAP Systems
BiPAP Machine
Ventilation / CPAP Systems
CPAP Machine
Ventilation / CPAP Systems
CPAP Machine (Auto)
Ventilation / CPAP Systems
CPAP Machine (Continuous Positive Airway Pressure)
Ventilation / CPAP Systems
Capnograph (EtCO2 Monitor)
Ventilation / CPAP Systems
Continuous Positive Airway Pressure (CPAP) Fixed
Ventilation / CPAP Systems
Flutter Valve / Acapella Device
Ventilation / CPAP Systems
High-Frequency Chest Wall Oscillation (The Vest)
Ventilation / CPAP Systems
Home Mechanical Ventilator (e.g., Trilogy)
Ventilation / CPAP Systems
Home Oxygen Concentrator (Stationary)
Ventilation / CPAP Systems
Home Ventilator (Trilogy)
Ventilation / CPAP Systems
Incentive Spirometer
Ventilation / CPAP Systems
Liquid Oxygen System
Ventilation / CPAP Systems
Mandibular Advancement Device (MAD)
Ventilation / CPAP Systems
Mechanical In-Exsufflator (CoughAssist)
Ventilation / CPAP Systems
Nasal CPAP / High Flow Nasal Cannula (HFNC)
Ventilation / CPAP Systems
Nebulizer Compressor System
Ventilation / CPAP Systems
Nebulizer for Myasthenia Gravis
Ventilation / CPAP Systems
Oral Appliance (Mandibular Advancement Device)
Ventilation / CPAP Systems
Oxygen Concentrator (Portable)
Ventilation / CPAP Systems
Peak Expiratory Flow Meter (PEFM)
Ventilation / CPAP Systems
Peak Flow Meter
Ventilation / CPAP Systems
Pediatric Valved Holding Chamber (Spacer) with Mask
Ventilation / CPAP Systems
Portable Oxygen Concentrator (POC)
Ventilation / CPAP Systems
Pulse Oximeter (Home)
Ventilation / CPAP Systems
Speaking Valve (Passy-Muir Valve)
Ventilation / CPAP Systems
Tracheostomy Suction Machine (Portable)
Ventilation / CPAP Systems
Valved Holding Chamber (Spacer) with Mask
Ventilation / CPAP Systems
Absorbable Tack Fixation System (SecureStrap)
Surgical Support / Microscopes
Amplatz Renal Sheath
Surgical Support / Microscopes
Amplatz Super Stiff Guidewire
Surgical Support / Microscopes
Amplatzer Amulet LAA Occluder
Surgical Support / Microscopes
Aspiration Assist Device (AspireAssist)
Surgical Support / Microscopes
BRTO Kit (Balloon-occluded retrograde transvenous obliteration)
Surgical Support / Microscopes
Barostim Neo System
Surgical Support / Microscopes
Biliary Stent (Fully covered SEMS - Viabil)
Surgical Support / Microscopes
Biliary Stent (Metal - Taewoong Niti-S)
Surgical Support / Microscopes
Biliary Stent (Partially covered SEMS - ComVi)
Surgical Support / Microscopes
Biliary Stent (Plastic 7Fr-12Fr - Double pigtail)
Surgical Support / Microscopes
Biliary Stent (Plastic straight - Cotton-Leung)
Surgical Support / Microscopes
Biliary Stent (Uncovered SEMS - Wallstent)
Surgical Support / Microscopes
Biologic Mesh Matrix (e.g., Strattice, Alloderm)
Surgical Support / Microscopes
Bone Anchors (for Slings)
Surgical Support / Microscopes
Breast Tissue Expander
Surgical Support / Microscopes
Bulking Agent Injection Kit (Macroplastique/Deflux)
Surgical Support / Microscopes
CRT-P (Biventricular Pacemaker)
Surgical Support / Microscopes
Capsule Endoscopy System (PillCam SB3)
Surgical Support / Microscopes
Capsule Endoscopy Workstation (RAPID Software)
Surgical Support / Microscopes
CardioWest TAH
Surgical Support / Microscopes
CentriMag (Temporary VAD)
Surgical Support / Microscopes
Cholangioscope (SpyGlass DS Digital)
Surgical Support / Microscopes
Cholangioscope (SpyScope - Disposable)
Surgical Support / Microscopes
Colonic Stent (SEMS - Through-scope)
Surgical Support / Microscopes
Colonic Stent (Uncovered - For benign refractory stricture)
Surgical Support / Microscopes
Cystogastrostomy Stent (Double pigtail 7Fr x 2)
Surgical Support / Microscopes
Deep Brain Stimulator (DBS) IPG
Surgical Support / Microscopes
Double-J (DJ) Ureteral Stent (Standard)
Surgical Support / Microscopes
Dual-Sided Hernia Mesh (e.g., Proceed, Parietex)
Surgical Support / Microscopes
Duodenal Stent (SEMS - WallFlex)
Surgical Support / Microscopes
ECMO (Veno-Arterial) Circuit
Surgical Support / Microscopes
ECMO (Veno-Venous) Circuit
Surgical Support / Microscopes
ESD Knife (FlushKnife - Triangle tip)
Surgical Support / Microscopes
ESD Knife (IT-2 - Insulated-tip)
Surgical Support / Microscopes
EUS-FNA Needle (EchoTip Ultra 22G/25G)
Surgical Support / Microscopes
EUS-FNA Needle (Expect 19G - Standard flex)
Surgical Support / Microscopes
EUS-FNB Needle (Acquire 22G - Franseen tip)
Surgical Support / Microscopes
EUS-FNB Needle (SharkCore 22G)
Surgical Support / Microscopes
Endoscopic Band Ligation (Multi-band - 6 bands)
Surgical Support / Microscopes
Endoscopic Band Ligation (Single-band - Stiegmann-Goff)
Surgical Support / Microscopes
Endoscopic Clip Device (Resolution 360)
Surgical Support / Microscopes
Endoscopic Submucosal Dissection Knife (DualKnife J)
Surgical Support / Microscopes
Endoscopic Suturing Device (OverStitch)
Surgical Support / Microscopes
Endoscopic Suturing Device (X-Tack)
Surgical Support / Microscopes
Enteroscopy Overtube (Double-balloon - Fujifilm)
Surgical Support / Microscopes
Enteroscopy Overtube (Double-balloon)
Surgical Support / Microscopes
Enteroscopy Overtube (Single-balloon - Olympus)
Surgical Support / Microscopes
Esophageal Stent (Fully covered SEMS - WallFlex)
Surgical Support / Microscopes
Esophageal Stent (Partially covered - Evolution)
Surgical Support / Microscopes
Esophageal Stent (Ultraflex - Uncovered)
Surgical Support / Microscopes
Extravascular ICD (EV-ICD)
Surgical Support / Microscopes
Extravascular ICD (EV-ICD) System
Surgical Support / Microscopes
Fibrin Sealant (Tisseel)
Surgical Support / Microscopes
Gastric Band (LAGB - Lap-Band AP)
Surgical Support / Microscopes
Gastric Band (Realize Band - MRI compatible)
Surgical Support / Microscopes
HeartMate 3 (LVAD)
Surgical Support / Microscopes
HeartWare HVAD
Surgical Support / Microscopes
Hemospray (TC-325 Powder)
Surgical Support / Microscopes
Hemostatic Agent (Surgicel / Fibrillar)
Surgical Support / Microscopes
Hilar Stent (Y-configuration - Niti-S)
Surgical Support / Microscopes
Hydrophilic Guidewire (Zebra/Sensor)
Surgical Support / Microscopes
ICD - CRT-D (Biventricular)
Surgical Support / Microscopes
ICD - DR (Dual Chamber)
Surgical Support / Microscopes
Impella 2.5 (LV Support)
Surgical Support / Microscopes
Impella 5.0
Surgical Support / Microscopes
Impella CP
Surgical Support / Microscopes
Impella RP (Right Support)
Surgical Support / Microscopes
Impella RP (Right Ventricular Support)
Surgical Support / Microscopes
Implantable Cardioverter Defibrillator (ICD) - VR (Single)
Surgical Support / Microscopes
Intra-Aortic Balloon Pump (IABP)
Surgical Support / Microscopes
Intragastric Balloon (Elipse - Swallowable, self-emptying)
Surgical Support / Microscopes
Intragastric Balloon (Obalon - Gas-filled x3)
Surgical Support / Microscopes
Intragastric Balloon (Orbera 650mL - Fluid)
Surgical Support / Microscopes
Intragastric Balloon (Orbera 650mL)
Surgical Support / Microscopes
Intragastric Balloon (Spatz3 - Adjustable volume)
Surgical Support / Microscopes
Intrathecal Baclofen Pump (SynchroMed II)
Surgical Support / Microscopes
Jarvik 2000
Surgical Support / Microscopes
Jejunostomy Tube (J-Tube)
Surgical Support / Microscopes
LAMS (Spaxus - 8mm for gallbladder)
Surgical Support / Microscopes
Lumen-apposing Metal Stent (LAMS - AXIOS 10/15/20mm)
Surgical Support / Microscopes
Lumen-apposing Metal Stent (LAMS - AXIOS)
Surgical Support / Microscopes
Malecot Catheter
Surgical Support / Microscopes
Mirena / Copper T Intrauterine Device (IUD)
Surgical Support / Microscopes
MitraClip G4 System
Surgical Support / Microscopes
Nephrostomy Balloon Dilator
Surgical Support / Microscopes
Nitinol Guidewire (0.035 inch)
Surgical Support / Microscopes
OTSC - Fistula (FTRD - Full-thickness resection device)
Surgical Support / Microscopes
Optimizer Smart (CCM Device)
Surgical Support / Microscopes
Over-the-Scope Clip (OTSC - Bear claw)
Surgical Support / Microscopes
PEG Tube (Percutaneous Endoscopic Gastrostomy)
Surgical Support / Microscopes
PTFE Guidewire (0.035 inch)
Surgical Support / Microscopes
PTNS Needle Kit
Surgical Support / Microscopes
Pacemaker - DDD (Dual Chamber)
Surgical Support / Microscopes
Pacemaker - Leadless (Aveir VR)
Surgical Support / Microscopes
Pacemaker - Leadless (Micra AV)
Surgical Support / Microscopes
Pacemaker - SSI (Single Chamber)
Surgical Support / Microscopes
Pancreatic Stent (Fully covered SEMS - Niti-S)
Surgical Support / Microscopes
Pancreatic Stent (Plastic - Pigtail)
Surgical Support / Microscopes
Pancreatic Stent (Plastic 3Fr-7Fr - Geenen)
Surgical Support / Microscopes
Percutaneous Nephrostomy (PCN) Catheter
Surgical Support / Microscopes
Pezzer Catheter
Surgical Support / Microscopes
Pigtail Catheter (Percutaneous)
Surgical Support / Microscopes
Polypropylene Hernia Mesh (Standard)
Surgical Support / Microscopes
Port-A-Cath (Implantable Venous Port)
Surgical Support / Microscopes
PowerSpiral Enteroscopy (Olympus)
Surgical Support / Microscopes
Programmable VP Shunt Valve
Surgical Support / Microscopes
Prostate Biopsy Needle (18G)
Surgical Support / Microscopes
Protek Duo Cannula (RVAD)
Surgical Support / Microscopes
Responsive Neurostimulation (RNS) Device
Surgical Support / Microscopes
Sacral Neuromodulation Generator (InterStim)
Surgical Support / Microscopes
Sacral Neuromodulation Lead (InterStim)
Surgical Support / Microscopes
Shockwave Intravascular Lithotripsy (IVL) Catheter
Surgical Support / Microscopes
Silicone Breast Implant
Surgical Support / Microscopes
Silicone Punctal Plugs
Surgical Support / Microscopes
Stone Extraction Basket (N-Gage/Dakota)
Surgical Support / Microscopes
Stone Extraction Basket (Segura/Flat wire)
Surgical Support / Microscopes
Stone Extraction Basket (Zero Tip Nitinol)
Surgical Support / Microscopes
Subcutaneous ICD (S-ICD)
Surgical Support / Microscopes
Suprapubic Catheter Set
Surgical Support / Microscopes
Syncardia Total Artificial Heart
Surgical Support / Microscopes
TIPS Stent (Bare metal - Wallstent)
Surgical Support / Microscopes
TIPS Stent (Viatorr - 8mm/10mm)
Surgical Support / Microscopes
TIPS Stent (Wallgraft - Covered)
Surgical Support / Microscopes
TandemHeart
Surgical Support / Microscopes
TandemHeart Percutaneous VAD
Surgical Support / Microscopes
Tracheostomy Tube (Cuffed/Uncuffed, Fenestrated)
Surgical Support / Microscopes
Tru-Cut Biopsy Needle (Renal)
Surgical Support / Microscopes
Tumor Stent (Reinforced Polyurethane)
Surgical Support / Microscopes
Ureteral Access Sheath (10/12F)
Surgical Support / Microscopes
Ureteral Access Sheath (12/14F)
Surgical Support / Microscopes
Ureteral Balloon Dilator (High Pressure)
Surgical Support / Microscopes
Ureteral Catheter (Cone Tip)
Surgical Support / Microscopes
Ureteral Catheter (Open-Ended)
Surgical Support / Microscopes
Vagus Nerve Stimulator (VNS) Generator
Surgical Support / Microscopes
Watchman FLX Device
Surgical Support / Microscopes
Share this guide: