Does Retrojugular Route for Carotid Endarterectomy Increase the Risk of Internal Jugular Vein Thrombosis ?

Abstract

Two different approaches are available to perform carotid endarterectomy: the traditional antejugular or the retrojugular route. With retrojugular route, direct access to the carotid arteries necessitates median retraction and often collapse of the internal jugular vein (IJV). Therefore, we have prospectively evaluated the potential incidence of IJV thrombosis.

Is the Retrojugular Approach Safer Than the Conventional Approach for Carotid Endarterectomy?

“…Exposure limitations of the transverse incision can be overcome by accurate localization of the carotid bifurcation by techniques such as magnetic resonance arteriography (MRA) [18]. By way of comparison, Scavee et al [19], using the vertical incision for retrojugular access, had only one patient (5%) with vocal cord dysfunction. We have used vertical incisions, extended cranially as required to give good ICA exposure, and have had no vocal dysfunctions in our last 50 primary retrojugular CEAs.…”