Document Detail

Repair of carotid blow-out using a carotid sheath in a patient with recurrent thyroid cancer.
MedLine Citation:
PMID:  22515127     Owner:  NLM     Status:  In-Process    
The patient had thyroid cancer and underwent subtotal thyroidectomy. Local recurrence occurred on both sides 5 years and 6 months later. The sterno-hyoid muscle and sterno-thyroid muscle were severed and the tumor around the cricoid cartilage was removed. The tumor extended into the space between the right common carotid artery and internal jugular vein and was located under the right common carotid artery and vagus nerve on the lateral side. The carotid sheath was peeled off of the carotid artery quite easily. The right common carotid artery ruptured abruptly at the distal side during this procedure. The right common carotid artery had two layers, which were very fragile, so the direct suture or repair with a graft was impossible. The carotid artery could not be trapped with ligation because the cerebral vascular supply was not examined preoperatively. This portion was repaired using the remaining carotid sheath. However, re-bleeding occurred at the proximal portion of the previous laceration spontaneously. Fibrin glue with oxidized cellulose was initially used to seal the second small hole in this lesion. The second ruptured section was repaired using the remaining sterno-thyroid and sterno-hyoid muscles. The proximal portion of the right common carotid artery was reinforced with the harvested external jugular vein. These procedures resulted in hemostasis. Three-dimensional CT angiography showed irregular stenosis just after the operation, but it recovered 11 days later. No cerebral infarction occurred after the operation and the patient's general condition was good.
Hirofumi Oyama; Akira Kito; Hideki Maki; Kenichi Hattori; Tomoyuki Noda; Kentaro Wada
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Nagoya journal of medical science     Volume:  74     ISSN:  0027-7622     ISO Abbreviation:  Nagoya J Med Sci     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-04-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0412011     Medline TA:  Nagoya J Med Sci     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  193-8     Citation Subset:  IM    
Department of Neurosurgery, Ogaki Municipal Hospital, Ogaki 503-8502, Japan.
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