scholarly journals Unusual course of the vagus nerve passing anterior to the internal carotid artery during carotid endarterectomy

2021 ◽  
Vol 12 ◽  
pp. 278
Author(s):  
Ichiro Kawahara ◽  
Eri Shiozaki ◽  
Kosuke Soejima ◽  
Yuka Ogawa ◽  
Yoichi Morofuji ◽  
...  

Background: Carotid endarterectomy (CEA) is a conventional surgical technique to prevent ischemic stroke and the effectiveness for advanced lesions is established in many large studies. The vagus nerve is one of the cranial nerves that we usually encounter during CEA manipulation, which is identified as located posterior to the vessels in a position posterolateral to the carotid artery and posteromedial to the internal jugular vein. Case Description: We experienced an extremely rare case of the vagus nerve passing anterior to the internal carotid artery during CEA. Conclusion: We should be careful not to accidentally cut off because the variation of the vagus nerve can be mistaken for an ansa cervicalis. A delicate and complete dissection to understand the variation of the vagus nerve is crucial to minimize the risk of cranial nerve injury during CEA.

2021 ◽  
pp. 153857442199293
Author(s):  
Constantinos Zarmakoupis ◽  
George Galyfos ◽  
Grigorios Tsoukalos ◽  
Panagiota Dalla ◽  
Alexandra Triantafyllou ◽  
...  

This report aims to present a rare case of a common carotid artery (CCA) pseudoaneurysm with a concomitant internal carotid artery (ICA) stenosis that were treated with a hybrid technique. This strategy included the retrograde placement of a CCA covered stent under ICA clamping followed by standardized carotid endarterectomy. The technique will be discussed and compared with other possible treatments.


2010 ◽  
Vol 2010 ◽  
pp. 1-2 ◽  
Author(s):  
Tomonori Tamaki ◽  
Node Yoji ◽  
Norihiro Saito

The technical factors and surgical methods employed in carotid endarterectomy are controversial. In particular, whether or not to use an indwelling arterial shunt during carotid endarterectomy remains a source of conflict. We describe a rare case in which uncomplicated carotid endarterectomy was followed by distal internal carotid artery dissection and suggest that this devastating complication was due to intimal damage produced by the use of an indwelling arterial shunt.


Angiology ◽  
2010 ◽  
Vol 61 (7) ◽  
pp. 705-710 ◽  
Author(s):  
Erik Bagaev ◽  
A. Maximilian Pichlmaier ◽  
Theodosios Bisdas ◽  
Mathias H. Wilhelmi ◽  
Axel Haverich ◽  
...  

2008 ◽  
Vol 62 (suppl_5) ◽  
pp. ONS363-ONS370 ◽  
Author(s):  
Yusuf Izci ◽  
Roham Moftakhar ◽  
Mark Pyle ◽  
Mustafa K. Basşkaya

Abstract Objective: Access to the high cervical internal carotid artery (ICA) is technically challenging for the treatment of lesions in and around this region. The aims of this study were to analyze the efficacy of approaching the high cervical ICA through the retromandibular fossa and to compare preauricular and postauricular incisions. In addition, the relevant neural and vascular structures of this region are demonstrated in cadaveric dissections. Methods: The retromandibular fossa approach was performed in four arterial and venous latex-injected cadaveric heads and necks (eight sides) via preauricular and postauricular incisions. This approach included three steps: 1) sternocleidomastoid muscle dissection; 2) transparotid dissection; and 3) removal of the styloid apparatus and opening of the retromandibular fossa to expose the cervical ICA with the internal jugular vein along with Cranial Nerves X, XI, and XII. Results: The posterior belly of the digastric muscle and the styloid muscles were the main obstacles to reaching the high cervical ICA. The high cervical ICA was successfully exposed through the retromandibular fossa in all specimens. In all specimens, the cervical ICA exhibited an S-shaped curve in the retromandibular fossa. The external carotid artery was located more superficially than the ICA in all specimens. The average length of the ICA in the retromandibular fossa was 6.8 cm. Conclusion: The entire cervical ICA can be exposed via the retromandibular fossa approach without neural and vascular injury by use of meticulous dissection and good anatomic knowledge. Mandibulotomy is not necessary for adequate visualization of the high cervical ICA.


2016 ◽  
Vol 158 (6) ◽  
pp. 1077-1081
Author(s):  
Marcos Dellaretti ◽  
Laura T. de Vasconcelos ◽  
Jules Dourado ◽  
Renata F. de Souza ◽  
Renato R. Fontoura ◽  
...  

1985 ◽  
Vol 99 (5) ◽  
pp. 485-489 ◽  
Author(s):  
M. Hasegawa ◽  
W. Nishijima ◽  
I. Watanabe ◽  
M. Nasu ◽  
R. Kamiyama

AbstractA 36-year-old male with a primary chondroid is presented. This tumour arose from the base of the temporal bone and extended to the mastoid cavity. It involved the facial nerve and was adherent to the internal jugular vein and internal carotid artery. The tumour was excised and the patient has been carefully followed up for 10 years. He has shown no evidence of local recurrence, intracranial extension of the residual tumour and distant metastasis.


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