title: Carotid artery injury after endonasal surgery.
abstract: Carotid artery injury during endonasal surgery is the most feared and catastrophic complication. Internal carotid artery injury is more frequent during skull base surgery, and risk factors include acromegaly, previous revision surgery, and prior radiotherapy and bromocriptine therapy. Nasal packing is frequently used to gain hemostasis, often resulting in vascular occlusion. Recent research recommends the crushed muscle patch treatment as an effect hemostat that maintains vascular patency. Endovascular techniques are recommended for vascular control and complication management. Coil or balloon embolization is preferred in patients with adequate collateral cerebral blood flow, and stent-graft placement or bypass surgery is indicated in those who do not.
authors: Department of Surgery-Otorhinolaryngology, Head and Neck Surgery, University of Adelaide, North Terrace, Adelaide 5000, Australia.
authors: Rowan
authors: R
authors: Valentine
authors: Peter-John
authors: PJ
authors: Wormald
mesh_terms: D000783:Aneurysm / Q000150:complications; D017542:Aneurysm, Ruptured / Q000209:etiology / Q000628:therapy; D020212:Carotid Artery Injuries / Q000209:etiology*; D002343:Carotid Artery, Internal; D004724:Endoscopy / Q000009:adverse effects*; D006488:Hemostasis, Surgical; D006801:Humans; D007431:Intraoperative Complications; D019635:Neurosurgical Procedures / Q000009:adverse effects; D010256:Paranasal Sinuses / Q000601:surgery*; D012307:Risk Factors; D019291:Skull Base / Q000601:surgery*