PMC8019647_01
An illustration of the vascular injury and surrounding anatomy. The asterisk demonstrates the segmental loss of the carotid artery and the arrow points to the stub of proximal common carotid artery with multiple horizontal lacerations extending down to the bifurcation of the brachiocephalic trunk.
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fig1
There was a stub of CA proximally (Figure 1) that bore multiple lacerations from uncontrolled hemostat applications (Figure 2).
Intraoperative photograph detailing the operative site. The thyroid (T) is being retracted to expose the CA posteriorly. The transected distal CA is occluded with clamps (white arrow). The proximal CA is tenuously controlled with a clamp behind the sternoclavicular joint (yellow arrow).
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fig2
There was a stub of CA proximally (Figure 1) that bore multiple lacerations from uncontrolled hemostat applications (Figure 2).
In this intraoperative photograph, the yellow arrows point to both ends of the CA and the broken line illustrates the segmental vessel loss.
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fig3
There was such a large segment loss that interposition grafting or transposition was required to restore continuity (Figure 3).
Photograph of the excised segment of proximal CA with multiple lacerations.
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fig4
Therefore, the proximal stump was excised (Figure 4) and both ends ligated (Figure 5).
Intraoperative photograph demonstrating over sewn distal carotid artery with good hemostasis (yellow arrow). The ischemic right lobe of thyroid (T) is demonstrated in-situ before excision.
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fig5
Therefore, the proximal stump was excised (Figure 4) and both ends ligated (Figure 5).