scholarly journals Lessons Learned after Iatrogenic Complete Transection of the Right Common Carotid Artery with Segmental Vessel Loss

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Shamir O. Cawich ◽  
Wendell Dwarika ◽  
Fawwaz Mohammed ◽  
Michael J. Ramdass ◽  
Vindra Ragoonanan ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Multidisciplinary Approach ◽  
Penetrating Trauma ◽  
Lessons Learned ◽  
Penetrating Injuries ◽  
Iatrogenic Complication ◽  
Complete Transection ◽  
Flow Restoration ◽  
The Right ◽  
Carotid Arterial

Carotid arterial injuries occur in 5-6% of persons with penetrating trauma. Complete transection is rare in civilian practice and is most often due to penetrating injuries. Complete transection as an iatrogenic complication is rare. We present a case where we were required to repair a complete transection of the carotid artery with segmental loss which occurred as an iatrogenic complication during thyroidectomy. We could find no previous reports of this type of iatrogenic complication. The lessons learned during the management of this case were the following: (1) surgeons should call for help early, (2) a multidisciplinary approach ensures that all options are considered, (3) adhere to surgical principles of proximal and distal control, (4) always use atraumatic clamps to control vessels, and (5) flow restoration should be attempted, leaving carotid ligation as the last resort.

scholarly journals Transoral Penetrating Knife Injury in the Oral, Maxillofacial Region: A Case Report

2019 ◽  
Vol 3 (1) ◽  
pp. s-0039-1694003
Author(s):  
Lukas B. Seifert ◽  
Philipp Thönissen ◽  
Anna M. Teiler ◽  
Christoph Nau ◽  
Axel Thalhammer ◽  
...  
Keyword(s):  
Case Report ◽  
Vertebral Artery ◽  
Multidisciplinary Approach ◽  
Balloon Catheter ◽  
Cerebellar Infarction ◽  
Soft Tissue Reconstruction ◽  
Penetrating Injuries ◽  
Maxillofacial Region ◽  
Interventional Angiography ◽  
The Right

Penetrating injuries are a rare yet complex variety of oral and maxillofacial trauma and often require a multidisciplinary approach to treatment. The primary survey is always the first step in trauma management prior to proceeding with further evaluation and treatment. The following case report discusses the clinical strategy for a rare transoral and trans-spinal penetrating injury. A 42-year-old man presented with a penetrating metal injury through the oral cavity. A computed tomography scan revealed a 12.8-cm-long knife penetrating through the tongue, floor of the mouth, and hypopharynx reaching the spinal cord in close proximity to the right vertebral artery. The patient did not present with any neurological malfunctions. An emergency tracheotomy was performed for airway protection. A balloon catheter was inserted into the right vertebral artery using interventional angiography to prevent massive bleeding prior to extraction. The knife was then surgically removed, and soft tissue reconstruction was performed without major bleeding. Postoperative magnetic resonance imaging angiography showed no bleeding of the right vertebral artery, but there was mild cerebellar infarction. Early isolated paresis of the right arm returned to nearly normal function within 1 week. This case demonstrates that complex penetrating injuries of the oral and maxillofacial region require a structured and multidisciplinary approach to prevent further side effects and obtain an ideal clinical outcome.

Blunt traumatic transection of the right common carotid artery

Trauma ◽  
2016 ◽  
Vol 19 (2) ◽  
pp. 150-154
Author(s):  
Amani Jambhekar ◽  
Amy Maselli ◽  
Ryan Lindborg ◽  
Thomas Bobka ◽  
Bashar Fahoum ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Antiplatelet Therapy ◽  
Blunt Trauma ◽  
Common Carotid Artery ◽  
Dual Antiplatelet Therapy ◽  
Traumatic Injury ◽  
Complete Transection ◽  
Neurologic Deficits ◽  
Luminal Narrowing ◽  
The Right

Background Carotid injuries are infrequent following blunt traumatic injury but can have potentially devastating neurologic consequences. We present a case of a 31-year-old male with right common carotid transection after blunt trauma to the neck. Case report A 31-year-old male with no notable medical history presented as a trauma level one activation after riding his bicycle into an open car door causing a Zone II laceration of his right anterior neck. The patient was hemodynamically normal, had an intact airway and had no neurologic deficits on evaluation in the trauma bay. He underwent a computed tomography angiogram of his neck which revealed a focal dissection of the right common carotid artery causing a 70%–80% luminal narrowing suspicious for a grade II injury. The patient was taken to the operating room for exploration of his neck laceration. He was found to have a grade V injury with complete transection of the right common carotid artery through the intima and media with intact adventitia. The arterial injury was repaired with polytetrafluoroethylene interposition graft. Perioperatively, the patient was started on dual antiplatelet therapy. He recovered uneventfully without neurologic deficits. Conclusion Complete transection of the common carotid artery following blunt trauma is rarely reported. Based on a review of the literature regarding blunt carotid injuries, it is reasonable to repair such injuries with prosthetic graft followed by either systemic anticoagulation or dual antiplatelet therapy.

scholarly journals Bilateral linguofacial trunk - a case report

2012 ◽  
Vol 01 (04) ◽  
pp. 193-195
Author(s):  
Shankreppa D Desai ◽  
Ashwini B Nuchhi ◽  
Santoshkumar B Karjagi
Keyword(s):  
Carotid Artery ◽  
Image Interpretation ◽  
External Carotid Artery ◽  
Vascular Trauma ◽  
Arterial System ◽  
External Carotid ◽  
Lingual Artery ◽  
Male Cadaver ◽  
The Right ◽  
Carotid Arterial

AbstractDuring routine dissection of an adult male cadaver, a unique case of anomalous origin of linguofacial trunk from both the right and left external carotid arteries with no looping of lingual artery in its course and relative higher division of right common carotid artery at C3 vertebral level was observed. Although variations in the external carotid artery origin and branches are not uncommon it is necessary to document as these variations may increase the risk of accidental vascular trauma during head and neck surgeries. And this knowledge is also important for radiologists in the image interpretation of carotid arterial system.

Traumatic intracranial nail-gun injury of the right internal carotid artery causing pseudoaneurysm and caroticocavernous fistula

2021 ◽  
Vol 14 (8) ◽  
pp. e243789
Author(s):  
Christopher Alan Brooks ◽  
Ashraf Dower ◽  
Andrew Bonura ◽  
Nathan Manning ◽  
James Van Gelder
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Case Reports ◽  
Penetrating Trauma ◽  
Domestic Assault ◽  
Cerebrovascular Injury ◽  
The Face ◽  
The Right ◽  
Caroticocavernous Fistula

Penetrating trauma due to nail gun is an uncommon yet important clinical entity. There are numerous case reports describing these injuries, yet few describe those resulting in cerebrovascular injury. Laceration of cerebral blood vessels may result in significant intracranial haemorrhage and cerebral ischaemia, with catastrophic consequences. In the present study, we report a female patient who was shot in the face with a nail gun in a domestic assault. The nail entered her right cavernous sinus and lacerated her right internal carotid artery causing a pseudoaneurysm and a caroticocavernous fistula. This report details the approach to, and pitfalls of, managing a cerebrovascular injury due to penetrating intracranial nail. Catheter cerebral angiography is essential in the diagnosis and treatment of these injuries. Best treatment and outcomes require clinicians with expertise in endovascular and surgical repair strategies.

Endovascular Management of a Gunshot Wound Injury to the Innominate Artery and Brachiocephalic Vein

Vascular ◽  
2005 ◽  
Vol 13 (1) ◽  
pp. 58-61 ◽  
Author(s):  
Andries J. Werre ◽  
J. Adam van der Vliet ◽  
Jan Biert ◽  
Jan D. Blankensteijn ◽  
Leo J. Schultze Kool
Keyword(s):  
Carotid Artery ◽  
Innominate Artery ◽  
Vascular Lesions ◽  
Brachiocephalic Vein ◽  
Penetrating Injuries ◽  
Venous Involvement ◽  
Close Range ◽  
Endovascular Approach ◽  
Considerable Morbidity ◽  
The Right

Surgical repair of penetrating injuries of the thoracic outlet with combined arterial and venous involvement is associated with considerable morbidity and mortality. A 37-year-old man presented to the emergency room with a left-sided penetrating zone I neck injury caused by a close-range handgun shot. This had resulted in an injury to the innominate artery and the origin of the right common carotid artery, with shunting to the brachiocephalic vein. This was managed endovascularly by stenting of the innominate artery and by coiling of the origin of the carotid artery. An endovascular approach to this injury is feasible and has the advantage of appropriate visualization of the vascular lesions with limited blood loss during the repair.

Multidisciplinary Approach of a Very Rare Infected Verrucous Carcinoma of the Scrotum

2019 ◽  
Vol 70 (4) ◽  
pp. 1476-1478
Author(s):  
Laura Raducu ◽  
Adelaida Avino ◽  
Cristina-Nicoleta Cozma ◽  
Sorin Nedelea ◽  
Andra-Elena Balcangiu-Stroescu ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
Rare Disease ◽  
Chronic Inflammation ◽  
Male Patient ◽  
Multidisciplinary Approach ◽  
Verrucous Carcinoma ◽  
Surgical Excision ◽  
Diagnosis And Treatment ◽  
Wide Surgical Excision ◽  
The Right

Verrucous carcinoma of the scrotum is an extremely rare disease and most cases are thought to result from poor hygiene and chronic inflammation. Currently, it has not been well characterized, the etiology, diagnosis and treatment remaining poorly understood. We present the case of a 50-year-old male patient diagnosed with verrucous carcinoma of the right hemiscrotum. Wide surgical excision was performed. Favorable outcomes can be achieved by surgery, even without any adjuvant therapy, but patients should be carefully followed up.

WITHWomen: User Centered Approach to the Design and Development of a suite of Intimate Partner Violence Screening and Safety Planning Web-Applications (Preprint)

2020 ◽  
Author(s):  
Patricia O'Campo ◽  
Alisa Velonis ◽  
Pearl Buhariwala ◽  
Janisha Kamalanathan ◽  
Maha Awaiz Hassan
Keyword(s):  
Partner Violence ◽  
Web Applications ◽  
Lessons Learned ◽  
Evidence Based ◽  
Safety Planning ◽  
Future Design ◽  
Mhealth Technology ◽  
The Right ◽  
Safe Access ◽  
Health Applications

BACKGROUND The popularity of mHealth technology has resulted in the development of numerous applications for almost every type of self-improvement or disease management. M- and e-health solutions for increasing awareness about and safety around partner violence is no exception. OBJECTIVE These applications allow women to control access to these resources and provide unlimited, and with the right design features, safe access when these resources are needed. Few applications, however, have been designed in close collaboration with intended users to ensure relevance and effectiveness. METHODS We report here on the design of a pair of evidence-based m- and e-health applications to facilitate early identification of unsafe relationship behaviors and tailored safety planning to reduce harm from violence including the methods by which we collaborated with and sought input from population of intended users. RESULTS The demographic characteristics of those who participated in the various surveys and interviews to inform the development of our screening and safety-decision support app are presented in (Table 2). CONCLUSIONS Finally, we share challenges we faced and lessons learned that might inform future design efforts of m- and e-health evidence-based applications.

scholarly journals Role of Extradural Clinoidectomy and Optic Unroofing in Resection of an Anterior Clinoidal Meningioma with Encasement of the Internal Carotid Artery and Its Branches

2021 ◽  
Author(s):  
Sima Sayyahmelli ◽  
Zhaoliang Sun ◽  
Emel Avci ◽  
Mustafa K. Başkaya
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Skull Base ◽  
Vision Loss ◽  
Internal Carotid ◽  
Extent Of Resection ◽  
World Health ◽  
Who Grade ◽  
The Right ◽  
Supraclinoid Internal Carotid Artery

AbstractAnterior clinoidal meningiomas (ACMs) remain a major neurosurgical challenge. The skull base techniques, including extradural clinoidectomy and optic unroofing performed at the early stage of surgery, provide advantages for improving the extent of resection, and thereby enhancing overall outcome, and particularly visual function. Additionally, when the anterior clinoidal meningiomas encase neurovascular structures, particularly the supraclinoid internal carotid artery and its branches, this further increases morbidity and decreases the extent of resection. Although it might be possible to remove the tumor from the artery wall despite complete encasement or narrowing, the decision of whether the tumor can be safely separated from the arterial wall ultimately must be made intraoperatively.The patient is a 75-year-old woman with right-sided progressive vision loss. In the neurological examination, she only had light perception in the right eye without any visual acuity or peripheral loss in the left eye. MRI showed a homogeneously enhancing right-sided anterior clinoidal mass with encasing and narrowing of the supraclinoid internal carotid artery (ICA). Computed tomography (CT) angiography showed a mild narrowing of the right supraclinoid ICA with associated a 360-degree encasement. The decision was made to proceed using a pterional approach with extradural anterior clinoidectomy and optic unroofing. The surgery and postoperative course were uneventful. MRI confirmed gross total resection (Figs. 1 and 2). The histopathology was a meningothelial meningioma, World Health Organization (WHO) grade I. The patient continues to do well without any recurrence and has shown improved vision at 15-month follow-up.This video demonstrates important steps of the microsurgical skull base techniques for resection of these challenging tumors.The link to the video can be found at https://youtu.be/vt3o1c2o8Z0

scholarly journals Management of Distress in Patients with Cancer—Are We Doing the Right Thing?

2020 ◽  
Vol 54 (12) ◽  
pp. 978-984
Author(s):  
Joost Dekker ◽  
Kristi D Graves ◽  
Terry A Badger ◽  
Michael A Diefenbach
Keyword(s):  
Emotional Support ◽  
Hybrid Approach ◽  
Psychosocial Care ◽  
Evidence Base ◽  
Case Finding ◽  
Lessons Learned ◽  
Distress Screening ◽  
Underlying Assumption ◽  
Patients With Cancer ◽  
The Right

Abstract Background Screening for distress and referral for the provision of psychosocial care is currently the preferred approach to the management of distress in patients with cancer. To date, this approach has shown a limited effect on the reduction of distress. Recent commentaries have argued that the implementation of distress screening should be improved. On the other hand, the underlying assumption that a referral for psychosocial care is required for distressed patients can be questioned. This has led to the development of an alternative approach, called emotional support and case finding. Purpose In the context of finding innovative solutions to tomorrow’s health challenges, we explore ways to optimize distress management in patients with cancer. Methods and Results We discuss three different approaches: (i) optimization of screening and referral, (ii) provision of emotional support and case finding, and (iii) a hybrid approach with multiple assessments, using mobile technology. Conclusions We suggest continued research on the screening and referral approach, to broaden the evidence-base on improving emotional support and case finding, and to evaluate the utility of multiple assessments of distress with new interactive mobile tools. Lessons learned from these efforts can be applied to other disease areas, such as cardiovascular disease or diabetes.

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