Pneumothorax, pneumomediastinum, and dysphonia complicating awake transcarotid artery revascularization

Journal of Vascular Surgery Cases and Innovative Techniques
Ross M Clark, John A Curci

Abstract

A 59-year-old woman presented with advanced, symptomatic carotid artery stenosis in the setting of severe medical comorbidities including coronary artery disease, congestive heart failure with recent admission for exacerbation, and diabetes mellitus. She underwent awake transcarotid artery revascularization because of her medically high-risk status. Postoperatively, she was noted to have developed pneumothorax, pneumomediastinum, and dysphonia, thought to be secondary to entrained air during the course of low neck dissection for carotid artery exposure in the setting of partial airway obstruction and high negative intrathoracic pressures during the procedure. After conservative treatment, she ultimately enjoyed complete clinical resolution. This case demonstrates an unusual complication of awake transcarotid artery revascularization.

References

May 1, 1994·The Journal of Surgical Research·T A SalamR B Smith
Oct 28, 2008·The Journal of Emergency Medicine·Fatih ParmaksızogluMehmet B Unal
Feb 10, 2017·The Korean Journal of Thoracic and Cardiovascular Surgery·Mohammad Ali HosseinianYalda Soleimanifard

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Methods Mentioned

BETA
dissection
sedation

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