TY - JOUR
TI - Characterization of outcomes and practices utilized in the management of
internal carotid artery injury not requiring definitive endovascular
management
AU - London, Jr., Nyall R.
AU - AlQahtani, Abdulaziz
AU - Barbosa, Siani and
AU - Castelnuovo, Paolo
AU - Locatelli, Davide
AU - Stamm, Aldo and
AU - Cohen-Gadol, Aaron A.
AU - Elbosraty, Hussam
AU - Casiano, Roy
AU - Morcos,
AU - Jacques
AU - Pasquini, Ernesto
AU - Frank, Georgio
AU - Mazzatenta, Diego
AU - and Barkhoudarian, Garni
AU - Griffiths, Chester
AU - Kelly, Daniel and
AU - Georgalas, Christos
AU - Janakiram, Trichy N.
AU - Nicolai, Piero and
AU - Prevedello, Daniel M.
AU - Carrau, Ricardo L.
JO - Laryngoscope Investigative Otolaryngology
PY - 2021
VL - 6
TODO - 4
SP - 634-640
PB - Wiley
SN - 2378-8038
TODO - 10.1002/lio2.621
TODO - carotid artery injury; carotid artery ligation; embolization; endoscopic
skull base surgery
TODO - Background After internal carotid artery (ICA) injury during endoscopic
skull base surgery, the majority of patients undergo ICA embolization or
stenting to treat active extravasation or pseudoaneurysm development.
However, management practices when embolization or stenting is not
required have not been well described. The objective of this study was
to determine how patients with ICA injury but no embolization, stenting,
or ligation do long-term and ascertain the reconstruction methods
utilized. Methods Twenty-nine cases of ICA injury were identified in an
international multi-institutional retrospective review. Of these, we
identified six cases that were not treated with embolization, stenting,
or ICA sacrifice. Information was available for five cases. Results A
muscle patch was used in the immediate repair of each case. A nasoseptal
flap was used in one case. Prefabricated nasal tampons were used in all
cases. Nasal packing was initially left in for a median of 7 days prior
to removal. The initial muscle patch was reinforced with a second muscle
graft in one case. One case demonstrated ICA bleeding at the time of
packing removal and was repacked an additional week. Follow-up for each
of these cases was at least 2 years. No cases of subsequent carotid
rupture were found and none of these cases ultimately underwent
endovascular stenting. Radiation or proton therapy has not been
subsequently used in any of these patients. Conclusions This study
details the reconstruction, lessons learned, and long-term follow-up for
five cases of ICA injury not treated with embolization, stenting, or
ligation.
ER -