Extended Approach of Carotid Endarterectomy for High Cervical Lesions

Ohmori, Kazumi; Kamiyoshi, Shiduka; Kumagai, Tetsuya; Fukushima, Takanori; Sanada, Yasuhiro

doi:10.2335/scs.41.89

Surg. Cereb. Stroke

2013

DOI: 10.2335/scs.41.89

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Extended Approach of Carotid Endarterectomy for High Cervical Lesions

Kazumi Ohmori¹,

Shiduka Kamiyoshi²,

Tetsuya Kumagai³

et al.

Abstract: Carotid endarterectomy (CEA) is the main treatment for the cervical internal carotid artery stenosis, which is an important cause of transient ischemic attacks and strokes. The operation requires careful attention to technical details, and certain specific principles are

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Safe Upper Limit for Carotid Endarterectomy for High Cervical Lesions and Management for Difficult Distal Shunt Insertion

KUSUMI,

OKA,

KONDO

et al. 2023

Surg. Cereb. Stroke

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Carotid endarterectomy (CEA) for high cervical internal carotid artery (ICA) stenosis is challenging. The high cervical approach, a skull-based technique primarily used to address jugular foramen schwannomas, is useful for understanding the anatomy and for the successful removal of high cervical lesions. Herein, we present an anatomical description and demonstrate the upper limit of CEA and our internal shunt insertion technique for such difficult lesions. The internal jugular vein and lower cranial nerves are located above the ICA at the level of the C1 transverse process in the operative field, making it difficult to manage the ICA. Consequently, when an internal shunt catheter is used, the safe upper limit for CEA is at the level of the C2 body. For the upper limit, in difficult cases, the distal plaque should be treated first, thereby facilitating the insertion of the internal shunt.

show abstract

Safe Upper Limit for Carotid Endarterectomy for High Cervical Lesions and Management for Difficult Distal Shunt Insertion

KUSUMI,

OKA,

KONDO

et al. 2023

Surg. Cereb. Stroke

View full text Add to dashboard Cite

show abstract

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Extended Approach of Carotid Endarterectomy for High Cervical Lesions

Abstract: Carotid endarterectomy (CEA) is the main treatment for the cervical internal carotid artery stenosis, which is an important cause of transient ischemic attacks and strokes. The operation requires careful attention to technical details, and certain specific principles are

Cited by 1 publication

References 7 publications

Safe Upper Limit for Carotid Endarterectomy for High Cervical Lesions and Management for Difficult Distal Shunt Insertion

Safe Upper Limit for Carotid Endarterectomy for High Cervical Lesions and Management for Difficult Distal Shunt Insertion

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