Suzuki Tomoya, Kimura Toshikazu, Hasegawa Hirotaka, Irie Koreaki, Hong Sukwoo, Karagiozov Kostadin, Ichi Shunsuke
Department of Neurosurgery, The Jikei University Hospital, Minato-ku, Tokyo.
Department of Neurosurgery, Japanese Red Cross Medical Center, Shibuya-ku.
Surg Neurol Int. 2022 Mar 25;13:101. doi: 10.25259/SNI_185_2022. eCollection 2022.
A dissection beginning from a point distal to the endpoint of the carotid endarterectomy (CEA) is called distal carotid artery dissection (CAD), which is known as one of the significant surgical complications of CEA.
We present a case of distal CAD as a perioperative complication after CEA using indwelling shunt. We estimated this pathophysiology to be caused by the mechanical conflict of the inflated balloon with the elongated styloid process.
Since a distal CAD can cause severe, irreversible neurological deficits, preoperative assessment of the styloid process should be routinely performed in CEA.