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Title
1. Introduction
2. Prep and Drape
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a. Preparing the Field
b. Applying the First Layer of Drapes
c. Fixing the First Layer of Drapes to the Skin
d. Applying the Second Layer of Drapes
e. Setting up Electrocautery and Suction
3. Incision and Exposure
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a. Incision
b. Extending the Incision into Subcutaneous Tissue and Platysma
c. Increasing Exposure
d. Dissection Through the Investing Layer of Cervical Fascia Across the Medial Border of Sternocleidomastoid Muscle
e. Accessing the Vascular Sheath
f. Identification and Ligation of the Small Sternomastoid Branch of the Superior Thyroid Artery
g. Dissection of Carotid Sheath Vessels
h. Isolating Internal Carotid Artery with an Elastic Vascular Loop away from Bifurcation
i. Identification, Ligation, and Separation of the Anterior Attachment of the Posterior Belly of Digastric Muscle and the Common Facial Vein
j. Excising the Posterior Belly of Digastric Muscle
k. Technique for Controlling Hemorrhage from Accidental Vessel Injury
l. Further Dissection to Expose Aneurysm
m. More Technique for Controlling Hemorrhage from Accidental Vessel Injury
n. Finish Dissection to Expose the Entire Aneurysm
4. Excision of Aneurysmal Sac
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a. Division of External Carotid Artery
b. Division of the Internal Carotid Artery and Accessing the Lumen of the Aneurysm
c. Excision of Aneurysm Wall and Debridement
5. Carotid Arterioplasty
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a. Primary Repair of Common Carotid Artery Wall
b. Primary End-to-End Anastomosis of Internal Carotid Artery
c. Catheterization of Internal Jugular Vein and Insertion of Tissue Drain
6. Closure
7. Post-op Remarks
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Transcervical Open Repair of Extracranial Internal Carotid Artery Aneurysm
Miguel Angel Mendoza Romo-Ramírez, MD
1
;
Jasanai Sausameda-García, MD
2
;
Silverio Gutiérrez-Cruz, MD
2
;
Kevin Johnson-Molina, MD
2
;
Miguel Angel Mendoza-Romo, MD
3
;
Carlos Flores-Ramirez, MD
1
1
Hospital Central del Estado, Chihuahua, Mexico
2
Hospital General Regional #1. IMSS. Chihuahua, Mexico
3
State Coordination Mexican Social Security Institute. IMSS-BIENESTAR. San Luis Potosi, Mexico.
Tags:
Vascular Surgery
Neurosurgery
Multidisciplinary Surgery
Main Text
Procedure Outline
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Authors
MIGUEL ANGEL MENDOZA ROMO RAMIREZ
Jasanai Sausameda-García, MD
Silverio Gutiérrez-Cruz, MD
Kevin Johnson-Molina, MD
Miguel Angel Mendoza-Romo, MD
Carlos Flores-Ramirez, MD
Filmed At:
Hospital Central del Estado, Chihuahua, Mexico
Article Information
Publication Date
11/21/2024
Article ID
460
Production ID
0460
Volume
2024
Issue
460
DOI
https://doi.org/10.24296/jomi/460