{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T13:08:18Z","timestamp":1774444098622,"version":"3.50.1"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2023,12,5]],"date-time":"2023-12-05T00:00:00Z","timestamp":1701734400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction and importance:<\/jats:title>\n                    <jats:p>Intravascular ballistic embolism is a rare and complex medical condition, posing diagnostic and management challenges. It involves the migration of ballistic materials within the arterial system, often stemming from neck and chest injuries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation:<\/jats:title>\n                    <jats:p>A 13-year-old boy sustained a chest injury from an air rifle, leading to a pellet embolism in the right internal carotid artery, resulting in severe cerebral infarction. Despite intervention attempts, the lodged pellet left the patient with permanent hemiplegia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical discussion:<\/jats:title>\n                    <jats:p>Intravascular ballistic embolism, although infrequent, presents diagnostic and therapeutic complexities. Embolization can manifest after a delay, with neck and chest injuries serving as common entry points. This case raised potential embolization routes through the left ventricle or a chest wound to the aortic arch or right common carotid artery. Management strategies for intravascular ballistic embolism remain debated. Some cases are conservatively treated, while others undergo surgical or radiological procedures to remove the foreign body. These interventions carry risks, such as foreign body migration and reperfusion injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Effectively managing intravascular ballistic embolism necessitates a deep understanding of possible embolization routes and a careful evaluation of intervention risks. Collaborative research efforts are pivotal in establishing optimal management strategies for these intricate cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2023.109112","type":"journal-article","created":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T11:50:56Z","timestamp":1701863456000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Case report - Embolic shotgun pellet to the right internal carotid artery causing hemiplegia"],"prefix":"10.1097","volume":"114","author":[{"given":"Gnanakanesh","family":"Rajeeth","sequence":"first","affiliation":[{"name":"University Surgical Unit, Teaching hospital, Kelaniya, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gayathri","family":"Wijeweera","sequence":"additional","affiliation":[{"name":"Interdisciplinary Centre for Innovation in Biotechnology and Neurosciences, Faculty of Medical Sciences, University of Sri Jayewardenepura, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Saieswaran","sequence":"additional","affiliation":[{"name":"Consultant General Surgeon, Teaching Hospital, Polonnaruwa, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"issue":"1","key":"R1-28-20260325","first-page":"226","article-title":"The SCARE case report (SCARE) guidelines","volume":"84","author":"Agha,","year":"2020","journal-title":"Int. J. Surg."},{"key":"R2-28-20260325","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1097\/00005373-198202000-00015","article-title":"Shotgun pellet embolization from the chest to the middle cerebral arteries","volume":"22","author":"Alsofrom,","year":"1982","journal-title":"J. Trauma"},{"key":"R3-28-20260325","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1097\/00005373-198104000-00012","article-title":"Delayed cerebral embolization of a shotgun pellet with fatal consequences","volume":"21","author":"Gipe,","year":"1981","journal-title":"J. Trauma"},{"key":"R4-28-20260325","first-page":"239","article-title":"Bullet emboli to the systemic and venous circulation","volume":"107","author":"Michelassi,","year":"1990","journal-title":"Surgery"},{"issue":"4","key":"R5-28-20260325","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1097\/00005373-197804000-00002","article-title":"Missile emboli","volume":"18","author":"Rich,","year":"1978","journal-title":"J. Trauma"},{"key":"R6-28-20260325","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1016\/j.jvs.2019.02.004","article-title":"Systematic review of civilian intravascular ballistic embolism reports during the last 30 years","volume":"70","author":"Kuo,","year":"2019","journal-title":"J. Vasc. Surg."},{"key":"R7-28-20260325","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1097\/00005373-199510000-00030","article-title":"Carotid artery pseudoaneurysm and pellet embolism to the middle cerebral artery following a shotgun wound of the neck","volume":"39","author":"Cogbill,","year":"1995","journal-title":"J. Trauma"},{"key":"R8-28-20260325","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1016\/j.jvs.2011.07.091","article-title":"Shotgun wound and pellet embolism to the intracranial carotid artery","volume":"55","author":"Vaquero-Puerta,","year":"2012","journal-title":"J. Vasc. Surg."},{"key":"R9-28-20260325","article-title":"Look away: arterial and venous intravascular embolisation following shotgun injury","volume":"15","author":"Vedelago,","year":"2014","journal-title":"J. Trauma Manag. Outcomes"},{"key":"R10-28-20260325","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/S0890-5096(06)60716-4","article-title":"Gunshot pellet embolus to the middle cerebral artery","volume":"1","author":"Bahnini,","year":"1986","journal-title":"Ann. Vasc. Surg."},{"key":"R11-28-20260325","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1007\/BF02426469","article-title":"Peripheral vascular gunshot bullet embolus migration to the cerebral circulation: report and literature review","volume":"32","author":"Dadsetan,","year":"1990","journal-title":"Neuroradiology"},{"key":"R12-28-20260325","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1007\/BF02614925","article-title":"Shotgun pellet embolization to the intracranial internal carotid artery: report of a case and review of the literature","volume":"1","author":"Oser,","year":"1994","journal-title":"Emerg. Radiol."},{"key":"R13-28-20260325","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1097\/00005373-199511000-00034","article-title":"Delayed embolization of a shotgun pellet from the chest to the middle cerebral artery","volume":"39","author":"Stein,","year":"1995","journal-title":"J. Trauma"},{"key":"R14-28-20260325","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1177\/1925362118782079","article-title":"A case series of anterograde and retrograde vascular projectile embolization","volume":"8","author":"Chao,","year":"2018","journal-title":"Acad. Forensic Pathol."},{"key":"R15-28-20260325","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1007\/BF02426469","article-title":"Peripheral vascular gunshot bullet embolus migration to the cerebral circulation","volume":"32","author":"Dadsetan,","year":"1990","journal-title":"Neuroradiology"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261223012415?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261223012415?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2023.109112","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T10:19:41Z","timestamp":1774433981000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2023.109112"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":15,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2023.109112","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2024,1]]},"assertion":[{"value":"2023-11-01","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-03","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}