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Chapter 88 - Neck Hematoma after Carotid Surgery

from Section 12 - Post-Anesthesia Care Unit

Published online by Cambridge University Press:  03 August 2023

By
Garietta Falls  and
Jessica A. Lovich-Sapola
Edited by
Jessica A. Lovich-Sapola
Jessica A. Lovich-Sapola
Affiliation:
Cleveland Clinic, Ohio
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Summary

You are called to evaluate a patient on the floor who underwent a carotid endarterectomy earlier in the day. She is 68 years old, with a history of coronary artery disease, hypertension, and chronic obstructive pulmonary disease. Upon entering the room, you notice that she has significant neck swelling over the incision site. She also seems anxious and is unable to speak in full sentences. You apply a face mask/Ambu bag and have difficulty ventilating. What do you do next? Do you attempt to intubate, or do you open the wound?

Type
Chapter
Information
Anesthesia Oral Board Review
Knocking Out The Boards
 , pp. 370 - 371
Publisher: Cambridge University Press
Print publication year: 2023

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References

Baracchini, C, Gruppo, M, Mazzalai, F, et al. Predictors of neck bleeding after eversion carotid endarterectomy. J Vasc Surg 2011;54:69–705.CrossRefGoogle ScholarPubMed
Barash, PG, Cullen, BF, Stoelting, RK. Clinical Anesthesia, 5th ed. Philadelphia: Lippincott Williams & Wilkins, 2006, pp. 953–4.Google Scholar
Miller, RD, Fleisher, LA, Johns, RA, et al. Anesthesia, 6th ed. New York: Churchill Livingstone, 2005, p. 2105.Google ScholarPubMed
North American Symptomatic Carotid Endarterectomy Trial Collaborators. Beneficial effect of carotid endarterectomy in symptomatic patients with high grade carotid stenosis. New Engl J Med 1991;325:445–53.Google Scholar
Roussopoulou, A, Lazaris, A, Tsivgoulis, G, et al. Risk of perioperative neck haematoma in TIA and non-disabling stroke patients with symptomatic carotid artery stenosis undergoing endarterectomy within 14 days from cerebrovascular event. J Neurol Sci 2019;409:116590.CrossRefGoogle ScholarPubMed
Tomonori, T, Morita, A. Neck haematoma after carotid endarterectomy: risks, rescue, and prevention. Br J Neurosurg 2019;33:156–160.Google Scholar
Welling, RE, Ramadas, HS, Gansmuller, KJ. Cervical wound hematoma after carotid endarterectomy. Ann Vasc Surg 1989;3:229–31.CrossRefGoogle ScholarPubMed

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