Airway obstruction following carotid endarterectomy.
Upper airway obstruction after carotid endarterectomy is a rare but potentially fatal complication of carotid endarterectomy. Upper airway obstruction is also a well recognized complication after neck surgery involving the thyroid gland and cervical spine. The airway obstruction usually develops slowly over a few hours and the onset is unpredictable. We report a patient who developed upper airway obstruction 16 hours following carotid endarterectomy. She required re-intubation in the intensive care unit (ICU). Fibreoptic assessment demonstrated severe supraglottic and glottic oedema. Tracheostomy was performed on day 2 postoperatively. Serial fibreoptic assessment of the upper airway showed gradual resolution of glottic edema and decanulation was successful on day 43.
Kwok
O K
OK
Department of Anaesthesiology and Operating Theatre Services, Kwong Wah Hospital, Kowloon, Hong Kong.
Sun
K O
KO
Ahchong
A K
AK
Chan
C K
CK
D000368:Aged; D000402:Airway Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D001999:Bronchoscopy / Q000379:methods; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D004691:Endarterectomy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007819:Laryngeal Edema / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D007828:Laryngoscopy / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D014139:Tracheostomy / Q000379:methods*; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler