Medicina Fluminensis, Vol. 57 No. 2, 2021.
Case report
https://doi.org/10.21860/medflum2021_371657
Abruption of the common carotid artery origin with no neurological impairment
Josip Figl
orcid.org/0000-0001-6755-8656
; Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
Damir Halužan
; Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
Dražen Belina
; Department of Cardiac surgery, University Hospital Centre Zagreb, Zagreb, Croatia
Yvonne Lončarić
; Department of Anesthesiology, University Hospital Centre Zagreb, Zagreb, Croatia
Dino Papeš
orcid.org/0000-0001-7241-9693
; Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
Irena Šnajdar
orcid.org/0000-0002-4429-1095
; Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
Abstract
Abstract. Objective: In this case, we present a patient who despite iatrogenic common carotid artery disruption had no neurological impairment after vascular reconstruction. Case report: During the neck dissection in a young patient a complete abruption of the common carotid artery occurred. Median sternotomy was done for proximal bleeding control. Vascular reconstruction was done using temporary carotid shunting. The patient had no neurological consequences afterward. Conclusion: The lesion of major neck vessels is one of the most severe complications during the surgery which must be dealt with as soon as possible in best way in order to avoid permanent brain damage. In situations of iatrogenic lesions of major neck arteries heparin admission, which is usually normal therapy during vascular reconstruction, is not an option due to abrupt and uncontrollable bleeding. Thus, establishing surgically proximal and distal vascular control over the bleeding artery by vessel clamping and urgent placing of temporary intraluminal carotid shunting and best medical intraoperative therapy in this critical period of surgery might be the crucial therapeutic moment for brain protection.
Keywords
carotid artery injury; neck dissection; sternotomy
Hrčak ID:
255664
URI
Publication date:
1.6.2021.
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