Anesthetic Management During Emergency Surgical Ligation for Carotid Blowout Syndrome

Nulent, Casper G. A. Klein; Graaff, Henri J. D. de; Ketelaars, Rein; Sewnaik, Aniel; Maissan, Iscander M.

doi:10.1213/xaa.0000000000000352

Cited by 2 publications

(5 citation statements)

References 11 publications

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“…In cases with significant swelling or small deviation is small, evaluation becomes particularly difficult. 1 In contrast, ultrasonography can be used to evaluate the reduction position more objectively and directly, thereby improving treatment outcomes. However, ultrasonography of the nasal bones requires acoustic coupling material to adhere the entire ultrasonography probe to the nasal projection.…”

Section: Usefulness Of the Glove Finger Pad For Ultrasonography In Na...mentioning

confidence: 99%

“…E mergency common carotid artery (CCA) ligation for bleeding control during carotid blowout syndrome (CBS) has been reported rarely. 1,2 Common carotid artery ligation carries the risk of ischemic stroke. In a study of 37 patients with CBS undergoing an intervention of coil embolization, stent grafting, surgical ligation, and primary vessel repair or bypass grafting, 11% suffered peri-interventional stroke.…”

mentioning

confidence: 99%

“…Emergency common carotid artery (CCA) ligation for bleeding control during carotid blowout syndrome (CBS) has been reported rarely 1,2 . Common carotid artery ligation carries the risk of ischemic stroke.…”

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confidence: 99%

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Homolateral Embolic Stroke After Emergency Ligation of the Common Carotid Artery to Stop Heavy Bleeding Caused by Carotid Blowout Syndrome

Finsterer,

Mehri

2024

Journal of Craniofacial Surgery

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Emergency common carotid artery (CCA) ligation for bleeding control during carotid blowout syndrome with consecutive embolic stroke has been reported rarely. The patient is a 70-year-old man, who was suffering from acute profuse bleeding from the left superior thyroid artery into the piriformis sinus, which was not controlled other than by ligation of the left CCA. The cause of the bleeding remained unclear but was suspected to be related to his history of being positive for squamous cell carcinoma of the left hypopharynx with ari and postcricoid infiltration, diagnosed at age 58. Squamous cell carcinoma was treated with local resection, chemotherapy (docetaxel, carboplatin, and cetuximab), and radiotherapy. Neurological examination 4 days after CCA ligation revealed multiple subacute embolic strokes in the territory of the left middle cerebral artery, macroangiopathy of the extra and intracranial cerebral arteries, and hypoplasia of the left vertebral artery. This case demonstrates that carotid blowout syndrome may require CCA ligation when external carotid artery ligation is not possible, and that ligation can be complicated by an asymptomatic embolic stroke.

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Section: Usefulness Of the Glove Finger Pad For Ultrasonography In Na...mentioning

confidence: 99%

mentioning

confidence: 99%

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Homolateral Embolic Stroke After Emergency Ligation of the Common Carotid Artery to Stop Heavy Bleeding Caused by Carotid Blowout Syndrome

Finsterer,

Mehri

2024

Journal of Craniofacial Surgery

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“…Case study: Surgical intervention to stop massive arterial hemorrhage. Head and neck surgeon ligated common carotid using specific anesthetic strategy combined with ROTEM-guided massive transfusion protocol [42].…”

Section: Klein 2016mentioning

confidence: 99%

“…Surgical missteps can occur, resulting in large-volume hemorrhage both intraoperatively and post-operatively. If these situations arise, they may necessitate massive blood transfusion protocols, for which VETs can be employed to better guide resuscitation [42]. As an example, EXTEM (a form of ROTEM), was used by Durila et al to guide blood product transfusion in tracheostomy patients with coagulopathies.…”

Section: Head and Neck Surgerymentioning

confidence: 99%

Use of Thromboelastography and Rotational Thromboelastometry in Otolaryngology: A Narrative Review

Marsee

Shariff

Wiarda

et al. 2022

JCM

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In the field of otolaryngology—head and neck surgery (ENT), coagulopathies present unique diagnostic and therapeutic challenges. In both hyper- and hypocoagulable patients, management of coagulopathies requires intricate attention to the nature of hemostatic competence. Common coagulation tests (CCTs) offer only a snapshot of hemostatic competence and do not provide a clear insight into the patient’s real-time hemostatic condition. Viscoelastic tests (VETs) offer a holistic and concurrent picture of the coagulation process. Although VETs have found prominent utilization in hepatic transplants, obstetrics, and emergent surgical settings, they have not been fully adopted in the realm of otolaryngology. The objective of this manuscript is to provide an overview of the literature evaluating the current utilization and possible future uses of VETs in the field of otolaryngology. The authors performed a comprehensive literature search of the utilization of VETs in otolaryngology and identified applicable studies that included descriptions of viscoelastic testing. Twenty-five studies were identified in this search, spanning topics from head and neck oncology, microvascular free flap reconstruction, obstructive sleep apnea, adenotonsillectomy, facial trauma, and epistaxis. The applicability of VETs has been demonstrated in head and neck oncology and microvascular free flap management, although their pervasiveness in practice is limited. Underutilization of VETs in the field of otolaryngology may be due to a lack of familiarity of the tests amongst practitioners. Instead, most otolaryngologists continue to rely on CCTs, including PT, PTT, INR, CBC, fibrinogen levels, and thrombin time. Learning to perform, interpret, and skillfully employ VETs in clinical and operative practice can greatly improve the management of coagulopathic patients who are at increased risk of bleeding or thrombosis.

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Anesthetic Management During Emergency Surgical Ligation for Carotid Blowout Syndrome

Cited by 2 publications

References 11 publications

Homolateral Embolic Stroke After Emergency Ligation of the Common Carotid Artery to Stop Heavy Bleeding Caused by Carotid Blowout Syndrome

Homolateral Embolic Stroke After Emergency Ligation of the Common Carotid Artery to Stop Heavy Bleeding Caused by Carotid Blowout Syndrome

Use of Thromboelastography and Rotational Thromboelastometry in Otolaryngology: A Narrative Review

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