Repair of Carotid Blow-out Using a Carotid Sheath in a Patient with Recurrent Thyroid Cancer
نویسندگان
چکیده
The patient had thyroid cancer and underwent subtotal thyroidectomy. Local recurrence occurred on both sides 5 years and 6 months later. The sterno-hyoid muscle and sterno-thyroid muscle were severed and the tumor around the cricoid cartilage was removed. The tumor extended into the space between the right common carotid artery and internal jugular vein and was located under the right common carotid artery and vagus nerve on the lateral side. The carotid sheath was peeled off of the carotid artery quite easily. The right common carotid artery ruptured abruptly at the distal side during this procedure. The right common carotid artery had two layers, which were very fragile, so the direct suture or repair with a graft was impossible. The carotid artery could not be trapped with ligation because the cerebral vascular supply was not examined preoperatively. This portion was repaired using the remaining carotid sheath. However, re-bleeding occurred at the proximal portion of the previous laceration spontaneously. Fibrin glue with oxidized cellulose was initially used to seal the second small hole in this lesion. The second ruptured section was repaired using the remaining sterno-thyroid and sterno-hyoid muscles. The proximal portion of the right common carotid artery was reinforced with the harvested external jugular vein. These procedures resulted in hemostasis. Three-dimensional CT angiography showed irregular stenosis just after the operation, but it recovered 11 days later. No cerebral infarction occurred after the operation and the patient's general condition was good.
منابع مشابه
ایسکمی تأخیری مغزی بدنبال ترمیم ترومای نافذ شریان کاروتید خارجی
Introduction: Penetrating trauma to anterior neck can induce cerebral ischemia due to carotid artery injury. Brain ischemia also can present after surgical carotid repairs. Early diagnosis and suitable treatment modality prevent from permanent neurologic deficit post operatively. Case Report: A 30 years old man with stab wound to zone two left side of neck underwent exploration and penrose i...
متن کاملReport of a Variation of the Right Common Carotid Artery
Carotid artery is the most important artery that carries the major part of the blood supply to the head and neck. The branching of the common carotid artery usually occurs at the upper edge of the thyroid cartilage. The placement of carotid sinus has also increased its importance in this area. Considering the clinical importance of knowledge about carotid artery variations, this case is reporte...
متن کاملCarotid angioplasty and stenting in a patient with high grade stenosis of Internal Carotid Artery associated with both vertebral arteries and contralateral carotid occlusion
Severe internal carotid artery (ICA) stenosis is a common cause of cerebrovascular accident (CVA) in middle-aged patients. Contralateral carotid occlusion (CCO) in patients with severe ICA stenosis is associated with high risk of CVA. Carotid endarterectomy (CEA) is associated with more complications in patients with CCO than those without CCO. In this study, we present the case of a 61-year-ol...
متن کاملNon-recurrent nerve from the vagus anterio-medially located in the carotid sheath.
Non-recurrent inferior laryngeal nerve (ILN) arising from the vagus nerve is a rare anatomic variation. The vagus descends vertically in the cervical neurovascular bundle, between and posterior to common carotid artery (CCA) and internal jugular vein (IJV). The vagus has also some anatomic variations. We present a case of two coincident anatomic variations both ILN and the vagus nerve. A patien...
متن کامل