Anatomia microcirúrgica da artéria carótida externa: um estudo estereoscópico

Abstract

Background: Knowledge of the anatomical structures of the external carotid artery by means of stereoscopic study may yield better results in microsurgery of the external carotid artery. Objective: To describe the structures of the external carotid artery under stereoscopic view, identifying its multiple aspects. Methods: The cervical regions of twelve cadavers were dissected using a surgical microscope with 3 to 40 X magnification. The anatomical dissections were documented using the technique to obtain three-dimensional images (3D), aiming at producing stereoscopic images. Results: The use of the stereoscopic technique allowed a tri-dimensional approach to the extracranial arterial circulation, and the performance of surgical dissections such the combined approach to the posterior fossa and infratemporal fossa, making microvascular surgery and neurosurgical procedures more precise. Conclusion: The use of images obtained by the stereoscopic technique produced a more assertive result in relation to the anatomy study for microsurgical or neurosurgical procedures, allowing better analysis before performing complex neurosurgical procedures. ResumoContexto: O conhecimento das estruturas anatômicas da artéria carótida externa por meio do estudo estereoscópico pode determinar melhores resultados em microcirurgias da artéria carótida externa. Objetivo: Descrever as estruturas da artéria carótida externa sob a visão estereoscópica, identificando seus múltiplos aspectos. Métodos: Doze regiões cervicais foram dissecadas, utilizando-se microscópico cirúrgico com 3 a 40X de aumento. As dissecções anatômicas foram documentadas utilizando-se a técnica para obtenção de imagens tridimensionais (3D), objetivando a produção de impressões estereoscópicas. Resultados: O uso da técnica estereoscópica possibilitou a abordagem da circulação arterial extracraniana, sendo realizados estudos cirúrgicos do tipo combinado fossa posterior e fossa infratemporal, tornando as microcirurgias e os procedimentos neurocirúrgicos vasculares mais precisos. Conclusão: O uso das imagens obtidas pela técnica estereoscópica produziu um resultado mais assertivo em relação ao estudo da anatomia para a microcirurgia e procedimentos neurocirúrgicos, facilitando melhor aprendizado previamente à realização de procedimentos complexos em neurocirurgia.Palavras-chave: visão estereoscópica; artéria carótida externa; imagens tridimensionais.

Descrição anatômica da artéria carótida externa e seus ramos na preguiça-comum

“…Diante disso, o estudo da artéria carótida externa (ACE) se faz necessário devido às estruturas anatômicas que são por ela vascularizadas (Isolan et al, 2012), destacando-se, ainda, a sua participação, na circulação extracraniana, onde seus ramos suprem deficiências decorrentes de possíveis oclusões (Longo e Zaclis, 1958). O desconhecimento da anatomia cirúrgica pode acarretar lesões, tendo a ACE uma anatomia complexa, que deve ser conhecida em profundidade por cirurgiões (Isolan et al, 2012), o que torna, portanto, o conhecimento da vascularização dessa artéria (a.) e de seus ramos de grande relevância para a preservação do bicho-preguiça.…”

Anatomia microcirúrgica da artéria carótida externa: um estudo estereoscópico

“…Despite the classical reports on the multiple communications between the external and the internal carotid systems, the article published in the current issue of J Vasc Bras describes the path of all its branches and most relevant anastomosis 1 . Clinical and surgical use of this knowledge is not restricted to neurosurgery.…”

“…They confirm the current concepts of the Guideline on the Management on the of Patients With Extracranial Carotid and Vertebral Artery Disease 3 from 2011, where it is possible to find guidelines for the use of carotid stents, besides a comparative analysis of outcomes in patients treated with stent placement and those treated by endarterectomy 3 . Therefore, the study of carotid artery anatomy is especially important, especially for the performance of carotid endarterectomy, which makes the article by Isolan et al significant from the point of view of clinical-surgical applicability 1 . Among the applications in the field of Angiology and Vascular Surgery, it should be emphasized the selection criteria for symptomatic patients, based on the NASCET cooperative study 2 .…”

“…There is strong evidence that the degree of stenosis is directly proportional to the benefit of intervention 2,3 . The statement that stereoscopic images give an idea of depth, which is not achievable with conventional bidimensional images, is quite relevant in the discussion of this subject 1 . Tridimensional perception has substantially increased in the medical literature, as well as in the media in general, and it is also well addressed in the article 1 .…”

“…The statement that stereoscopic images give an idea of depth, which is not achievable with conventional bidimensional images, is quite relevant in the discussion of this subject 1 . Tridimensional perception has substantially increased in the medical literature, as well as in the media in general, and it is also well addressed in the article 1 . It is expected that in the near future there will be better conditions for the understanding of tridimensional techniques and the use of stereoscopic images.…”