Carotid artery injury in endoscopic endonasal surgery: Risk factors, prevention, and management.

IF 1.7 4区环境科学与生态学 Q4 ENVIRONMENTAL SCIENCES Coastal Management Pub Date : 2022-03-22 eCollection Date: 2022-03-01 DOI:10.1002/wjo2.7

Rahul K Sharma, Alexandria L Irace, Jonathan B Overdevest, David A Gudis

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引用次数: 0

Abstract

Objective: 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.

Data sources: Comprehensive literature review.

Methods: Relevant literature was reviewed using PubMed/MEDLINE.

Results: 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.

Conclusions: 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.

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内窥镜鼻内镜手术中的颈动脉损伤：风险因素、预防和处理。

目的：内窥镜鼻窦和颅底手术越来越受欢迎。本综述旨在描述内窥镜鼻内镜手术（EES）中颈内动脉损伤的风险因素，强调预防措施，并说明关键的管理原则：综合文献综述：方法：使用PubMed/MEDLINE检索相关文献：结果：在 EES 中颈动脉损伤非常罕见，大多数研究报告的发生率低于 0.1%。解剖异常、剥离边缘宽以及特定的提供者和医院因素可能会增加损伤风险。多学科团队、全面的术前成像、患者风险评估以及正规的血管急症培训可降低风险。处理方案应强调对损伤部位的正确观察、液体置换、快速包装、血管造影和血管内止血技术：尽管 EES 是一种相对安全的手术，但颈动脉损伤是一种破坏性并发症，需要在手术计划中予以充分考虑。重要的预防措施包括识别有明显风险因素的患者并进行术前成像。要降低发病率和死亡率，最终需要多学科团队和管理协议。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Coastal Management 环境科学-环境科学

CiteScore

6.00

自引率

0.00%

发文量

审稿时长

>36 weeks

期刊介绍： Coastal Management is an international peer-reviewed, applied research journal dedicated to exploring the technical, applied ecological, legal, political, social, and policy issues relating to the use of coastal and ocean resources and environments on a global scale. The journal presents timely information on management tools and techniques as well as recent findings from research and analysis that bear directly on management and policy. Findings must be grounded in the current peer reviewed literature and relevant studies. Articles must contain a clear and relevant management component. Preference is given to studies of interest to an international readership, but case studies are accepted if conclusions are derived from acceptable evaluative methods, reference to comparable cases, and related to peer reviewed studies.