CEAの術野展開におけるゴムフック吊り上げ法の有用性

概要

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We report on our surgical technique, "the rubber band and hook method," for carotid endarterectomy (CEA). Since carotid stenosis is frequently high-positioned in the Japanese population, even a small transposition of the carotid artery downwards makes it safer and easier to manipulate the distal internal carotid artery. With rubber bands and small skin hooks, we mobilize the carotid artery by holding up the carotid sheath. The author (S.O.) performed 60 CEAs from 2001 to 2006 using this method. No perioperative stroke or hematoma formation that required surgical removal was observed. Postoperative angiography confirmed optimal patency in all cases. We observed, however, 1 persistent case (1.6%) and 2 transient cases (3.3%) of hoarseness due to superior laryngeal nerve palsy related to surgical maneuvers. In this article, we report the effectiveness of our technique in ensuring the operative field along with the potential benefit to reduce bleeding by not separating the backside of the carotid artery. We also underscore the need of meticulous manipulation in securing the distal internal carotid artery and superior thyroid artery to prevent the superior laryngeal nerve palsy.
日本脳卒中の外科学会の論文
2009-01-31