Carotid artery surgery

Severe tracheal deviation detected on preoperative chest radiographs is one of the risk factors for difficult tracheal intubation and difficulty in ventilation using an endotracheal tube after tracheal intubation when managing the airway through tracheal intubation under general anesthesia. In this report, we describe the cadaver of an 81-year-old woman with marked tracheal deviation due to meandering multiple aortas. This report details the importance of anatomical knowledge in developing a detailed airway management plan...

Aortic dissection (AD) is a rare but often lethal condition if not properly and urgently treated. Most often, patients arrive with acute hemodynamic instability and ripping chest agony. The patient's life depends critically on a correct diagnosis made as soon as possible. We describe a 60-year-old man who arrived at the emergency room with symptoms of a brain stroke, including poor consciousness, left-sided weakness, and speech disturbance associated with hemodynamic instability, and chest pain. Thoracic aortic arch dissection was observed on CT angiography (CTA)...

Neonatal hypoxic-ischemic brain injury (HIBI) results in part from excess reactive oxygen species and iron-dependent lipid peroxidation (i.e. ferroptosis). The vitamin D precursor 7-dehydrocholesterol (7-DHC) may inhibit iron-dependent lipid peroxidation. Primary neurons underwent oxygen and glucose deprivation (OGD) injury and treatment with 7-DHC-elevating medications such as cariprazine (CAR) or vehicle. Postnatal day 9 mice underwent sham surgery or carotid artery ligation and hypoxia and received intraperitoneal CAR...

INTRODUCTION: Ocular ischemic syndrome (OIS) is a rare presentation of atherosclerotic carotid artery stenosis that can result in permanent visual loss. This severely disabling syndrome remains under diagnosed and undertreated due to lack of awareness; especially since it requires expedited multidisciplinary care. The relevance of early diagnosis and treatment is increasing due to an increasing prevalence of cerebrovascular disease. METHODS: The long-term visual and cerebrovascular outcomes following intervention for non-arteritic OIS remain poorly described and was the objective of this concise review...

INTRODUCTION: Radiation-induced carotid artery stenosis (RICS) is a well-described phenomenon seen after head and neck cancer radiation. Previously published literature suggests that compared to atherosclerotic disease, RICS may result in worse long-term outcomes and early restenosis. This study aims to evaluate the effect of radiation on long-term outcomes after various carotid revascularization techniques using a multi-center registry database. METHODS: Patients in the Society for Vascular Surgery (SVS) Vascular Quality Initiative (VQI) registry for carotid artery intervention (carotid endarterectomy, CEA; transfemoral carotid artery stenting, CAS; transcarotid artery revascularization, TCAR), who are 65 years or older were included in the study...

BACKGROUND: Moyamoya disease (MMD) is a progressive, occlusive disease of the internal carotid arteries and their proximal branches, with the subsequent development of an abnormal vascular network that is rupture-prone. Steno-occlusive changes in the posterior cerebral arteries (PCAs) may contribute to worsened outcomes in patients with MMD; however, there is little information on the incidence and natural history of posterior circulation MMD (PCMMD). We describe clinical PCMMD characteristics in a large cohort of patients with MMD...

This study provides a single-center experience involving intracapsular dissection for Shamblin II carotid body tumors (CBTs) and compares the outcomes with the classic technique of subadventitial resection. Based on the preliminary results, it seems that the enucleation technique facilitates the dissection of carotid body tumors, offering protection to cranial nerves and the internal/external/common carotid artery by utilizing the capsule as a barrier. The classic subadventitial resection approach and the enucleation technique have comparable postoperative complications...

Pseudoaneurysm of the internal carotid artery following otogenic infection is rare but leads to catastrophic outcomes. In our case series, we present two patients with ICA pseudoaneurysm complicated by malignant otitis externa, and we emphasise the importance of timely diagnosis and management to prevent fatal outcomes. A pseudoaneurysm should be ruled out in a patient with malignant otitis externa presenting with recurrent epistaxis or ear bleed.

There is limited evidence of N-butyl cyanoacrylate (n-BCA) use in endovascular embolization of traumatic face and neck vessel injuries. We investigated the safety and effectiveness of n-BCA for this purpose. We retrospectively analyzed consecutive patients presenting to a Level 1 trauma center between April 2021 and July 2022. We included patients aged ≥ 18 years old with any vessel injury in the face and neck circulation requiring n-BCA embolization. The primary endpoint was n-BCA effectiveness defined as immediate control of active bleeding post-embolization...

Among the various anatomical landmarks during neck dissection, digastric muscle is one of the most important. It is well known that all important blood vessels in neck lies deep to digastric. Thus, it acts as a safety landmark during neck dissection. In this article we describe a variation in vascular anatomy with relation to posterior belly of digastric that has not been reported so far during live surgery. Surgeon performing neck dissection should have a detailed knowledge of anatomy and infrequent anatomical variation...

<b/>The intracranial segment of the internal carotid artery located inside the skeleton structure of skull base or inside the skull has clear anatomical landmarks and fixed anatomical structure. However, the parapharyngeal segment of the internal carotid artery located outside the cranial is surrounded by soft tissues, lacks clear and recognizable anatomical landmarks and sometimes has anatomical variation, which is closely related to transnasal endoscopic surgery. Intraoperative accidental injury can lead to serious complications or even death...

Objective: To investigate the clinical features of patients with congenitally enlarged bony portions of the Eustachian tube（ET）. Methods: The medical history, physical examination, hearing test, temporal bone high resolution computed tomography（HRCT） of six patients（nine ears） with congenitally enlarged bony portion of the ET were retrospectively analyzed. Results: Four patients were men and two were women. The minimum, maximum, and average ages were 5, 21, and（14...

Objective: To explore the selection, efficacy and application of indications for parapharyngeal space tumor resection assisted by plasma and HD endoscopic system through oral approach. Methods: The clinical data of 23 patients with parapharyngeal space tumor resection assisted by plasma and HD endoscopic system were retrospectively analyzed in Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Bengbu Medical University from January 2013 to June 2023. All cases were examined by high-resolution CT and MRI before operation, and some cases were examined by CTA or DSA...

Blunt carotid artery injury (BCI) poses a rare yet severe threat following vascular trauma, often leading to significant morbidity and mortality. We present a case of a 33-year-old male who suffered complete thrombotic occlusion of the right common carotid artery (CCA) following a workplace accident. Clinical evaluation revealed profound neurological deficits, prompting multidisciplinary surgical intervention guided by the Denver criteria (Grade I - disruption inside the vessel that results in a narrowing of the lumen by less than 25%; Grade II - dissection or intramural hematoma causing greater than 25% stenosis; Grade III - comprises pseudoaneurysm formation; Grade IV - causes total vessel occlusion; Grade V - describes vessel transection with extravasation)...

Objective: To analyze the characteristics of cervical lymph node metastasis in tongue squamous cell carcinoma (TSCC). Methods: A retrospective study was conducted. A total of 329 patients with TSCC who underwent en bloc resection of primary tumor and neck dissection in the Second Xiangya Hospital of Central South University from June 2010 to March 2018 were included. There were 283 males and 46 females, aged from 26 to 80 years. All patients underwent the modified neck dissection. The main difference between the modified neck dissection and the traditional neck dissection lay in the managements of unconventional lymph nodes...

Transcarotid artery revascularization (TCAR) has risen as a promising minimally invasive intervention for high-risk patients with favorable anatomy. TCAR's noninferiority to carotid endarterectomy regarding stroke is reliant on its flow reversal technology and lack of aortic arch manipulation. We present the case of a 79-year-old man with a chronically occluded inferior vena cava who safely underwent staged bilateral TCAR for bilateral high-grade carotid artery stenosis. Although chronic inferior vena cava occlusion alters flow mechanics, we suspect that any pressure gradient facilitating retrograde flow from the carotid artery to the femoral vein provides neuroprotective benefits...

OBJECTIVE: This study aims to report the efficacy and safety of double-fenestrated physician-modified endovascular grafts (PMEGs) for total aortic arch repair with at least 3 years follow up. METHODS: All consecutive patients with a pathological aortic arch who underwent aortic arch repair combined with homemade double-fenestrated stent-graft from 2017 to 2020 were reviewed. RESULTS: 74 patients were treated for pathological arch conditions with double-fenestrated PMEG...

BACKGROUND: The aim of this study was to clarify when and from which blood vessels indirect revascularization develops after combined revascularization surgery for moyamoya disease and how the donor vessels that undergo direct revascularization change in the medium to long term. In particular, we focused on the middle temporal artery (MTA), which has not received much attention in indirect revascularization surgery for moyamoya disease until now. METHODS: We targeted 20 sides that were suitable for evaluating the diameter of the external carotid artery system involved in combined revascularization surgery among moyamoya disease patients who underwent a composite revascularization procedure utilizing a 'U'-shaped skin incision encircling the parietal branch of the superficial temporal artery (STA) at our institution from 2018 to 2023...

BACKGROUND: It is frequently observed that patients with first-ever acute ischemic stroke (AIS) have a common occurrence of asymptomatic coronary artery disease (CAD). This condition is associated with a poor prognosis. Early detection and recognition of asymptomatic CAD in first-ever AIS patients may optimize the clinical management and ultimately lead to improved outcomes. The aim of this study was to investigate the role of aortic arch plaque (AAP) detected through combined computed tomography angiography (CTA) as an early predictor of asymptomatic CAD in patients with first-ever AIS without prior diagnosis of CAD...

BACKGROUND: Microvascular visualization is crucial in understanding the mechanisms of several pathologies. For instance, visualization of the tumor microenvironment is important in understanding angiogenesis and role in cancer progression. Visualization would provide insights to cancer diagnosis, predicting metastatic growth, and evaluating therapeutic protocols. Similarly, understanding the microvascular network could be beneficial for study of degenerative diseases and tissue repair...