Carotid artery injury in endoscopic endonasal surgery: Risk factors, prevention, and management.
carotid injury
complications
internal carotid
pituitary
pituitary adenoma
pituitary tumor
skull base surgery
surgical outcomes
transphenoidal
Journal
World journal of otorhinolaryngology - head and neck surgery
ISSN: 2589-1081
Titre abrégé: World J Otorhinolaryngol Head Neck Surg
Pays: United States
ID NLM: 101690857
Informations de publication
Date de publication:
Mar 2022
Mar 2022
Historique:
received:
17
06
2021
accepted:
19
10
2021
entrez:
27
5
2022
pubmed:
28
5
2022
medline:
28
5
2022
Statut:
epublish
Résumé
Endoscopic approaches for sinus and skull base surgery are increasing in popularity. The objective of this narrative review is to characterize risk factors for internal carotid artery injury in endoscopic endonasal surgery (EES), highlight preventative measures, and illustrate key management principles. Comprehensive literature review. Relevant literature was reviewed using PubMed/MEDLINE. Carotid artery injury in EES is rare, with most studies reporting an incidence below 0.1%. Anatomic aberrancies, wide dissection margins, as well as specific provider and hospital factors, may increase the risk of injury. Multidisciplinary teams, comprehensive preoperative imaging, patient risk assessment, and formal training in vascular emergencies may reduce the risk. Management protocols should emphasize proper visualization of the injury site, fluid replacement, rapid packing, angiography, and endovascular techniques to achieve hemostasis. While EES is a relatively safe procedure, carotid artery injury is a devastating complication that warrants full consideration in surgical planning. Important preventative measures include identifying patients with notable risk factors and obtaining preoperative imaging. Multidisciplinary teams and management protocols are ultimately necessary to reduce morbidity and mortality.
Identifiants
pubmed: 35619937
doi: 10.1002/wjo2.7
pii: WJO27
pmc: PMC9126167
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
54-60Informations de copyright
© 2022 The Authors. World Journal of Otorhinolaryngology ‐ Head and Neck Surgery published by John Wiley & Sons, Ltd on behalf of Chinese Medical Association.
Déclaration de conflit d'intérêts
The authors declare no conflict of interest.
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