Abstract:
BACKGROUND:Surgical exposure of a high carotid bifurcation (HCB) for carotid endarterectomy (CEA) can be technically challenging due to the presence of bony structures in the most cranial portion of the neck and is associated with significant morbidity making carotid artery stenting (CAS) a common alternative. However, a high transverse neck incision with subplatysmal flaps facilitates CEA in these patients without additional exposure techniques. We present a high transverse neck incision with subplatysmal flaps as an alternative to the standard surgical exposure of the carotid bifurcation to facilitate CEA in patients with HCB. METHODS:Four patients with carotid bifurcations located cranial to the C3-4 vertebral interspace (identified on preoperative imaging) requiring intervention underwent CEA using a high transverse neck incision through an existing skin crease with subplatysmal flap elevation. CEA was performed in a standard fashion with bovine pericardial patch. RESULTS:Two male and 2 female patients with an average age of 65 years successfully underwent CEA using this incision. One patient underwent concurrent carotid body tumor excision. None of the patients required mandibulotomy or hyoid bone resection. Two patients required division of the posterior belly of the digastric muscle. There were no perioperative complications. Primary patency was 100% in the 4 patients with surveillance studies, and mean follow-up of 160 days (range 54-369 days). There were no significant cranial nerve injuries. No patient required conversion to an endovascular procedure due to inaccessibility of the lesion or subsequent interventions for incomplete endarterectomy. CONCLUSIONS:A high transverse incision with subplatysmal flaps is a safe, effective, and cosmetically preferable surgical approach in patients with HCB requiring carotid artery intervention and may be an alternative to CAS.
journal_name
Ann Vasc Surgjournal_title
Annals of vascular surgeryauthors
Farhat-Sabet A,Aicher BO,Tolaymat B,Coca-Soliz V,Nagarsheth KH,Ucuzian AA,Lubek JE,Toursavadkohi Sdoi
10.1016/j.avsg.2019.10.100subject
Has Abstractpub_date
2020-05-01 00:00:00pages
240-246eissn
0890-5096issn
1615-5947pii
S0890-5096(19)30970-7journal_volume
65pub_type
杂志文章abstract::Extrahepatic portal vein aneurysm is a rare clinical entity. The two most common locations for aneurysmal formation are at the confluence of the superior mesenteric vein (SMV) and the splenic vein, and at main portal vein trunk, just above the SMV-splenic vein confluence. In this article, two cases of extrahepatic por...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.02.046
更新日期:2011-11-01 00:00:00
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journal_title:Annals of vascular surgery
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journal_title:Annals of vascular surgery
pub_type: 杂志文章,随机对照试验
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更新日期:2013-02-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.avsg.2018.01.076
更新日期:2018-05-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章
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更新日期:2018-05-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.01.024
更新日期:2016-08-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.02.054
更新日期:2011-07-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章,多中心研究
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journal_title:Annals of vascular surgery
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journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169910092
更新日期:2000-09-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900026
更新日期:1997-03-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.10.019
更新日期:2012-07-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2017.01.009
更新日期:2017-07-01 00:00:00
abstract::Exposure of the distal internal carotid artery (ICA) above the level of the second cervical vertebra can be difficult and often require maneuvers such as division of the digastric muscle or mandibular subluxation. These techniques increase exposure but may not provide adequate access. We report a series of eight cases...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100160010010
更新日期:2001-01-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1007/s100160010082
更新日期:2001-05-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.02.049
更新日期:2012-02-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.05.002
更新日期:2013-01-01 00:00:00
abstract::Pseudoaneurysm of the internal mammary artery is an unusual complication of wounds to the chest. We report a case of a 41-year-old man who sustained a stab chest wound and posttraumatic pseudoaneurysm of the internal mammary artery, resulting in hemomediastinum and hemothorax. The patient was successfully treated usin...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2013.06.034
更新日期:2014-04-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-006-9007-1
更新日期:2006-03-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章
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更新日期:2006-05-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.07.016
更新日期:2011-02-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/S0890-5096(06)60832-7
更新日期:1990-11-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2014.05.006
更新日期:2014-10-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.04.033
更新日期:2017-10-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章,meta分析
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更新日期:2014-11-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
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更新日期:2017-01-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章
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更新日期:2018-08-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2014.12.016
更新日期:2015-01-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.06.157
更新日期:2017-11-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2007.12.007
更新日期:2008-03-01 00:00:00