This paper is only available as a PDF. To read, Please Download here.
Through a planned program of anticipation and repeated orientation of all surgical personnel to the problems and procedures to be followed, seventeen of nineteen instances of massive spontaneous hemorrhage of the carotid artery have been successfully controlled. The restoration and stabilization of the patient's vital signs by point-pressure control of bleeding, maintenance of adequate ventilation, and rapid blood volume restoration, together with the emergency mobilization of hospital facilities, have allowed all but three of these patients to undergo successful ligation. No neurologic defects have resulted, and all have been restored to their prior “blowout” ambulatory status. Removal of a portion of the medial clavicle often facilitated ligation and wound closure.
The common etiologic factor in this series of spontaneous hemorrhage of the carotid artery has been the combination of surgery for postirradiation recurrent cancer which was subsequently followed by wound breakdown secondary to tissue necrosis or fistula formation. In addition, tumor either grossly or microscopically has been present in at least seven instances. Three carotid artery hemorrhages in two patients occurred from infection alone after radical surgery.
The incidence of spontaneous hemorrhage of the carotid artery has significantly decreased since, at the time of surgery, skin incisions overlying the carotid are avoided, all carotids are routinely covered with muscle flaps, and antibiotic prophylaxis is employed.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to The American Journal of Surgery
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Ligature of arteries, with particular reference to carotid occlusion and the circle of Willis.Brit. J. Surg. 1947; 35: 43
- Les accidents cérébraux et oculaires consécutifs à la ligature de la carotide primitive.Étude expérimentale et clinique, Thesis No. 292. 1906; (Paris)
- Carotid artery ligation in surgery of the head and neck.Cancer. 1955; 8: 712
- Carotid body tumors.Ann. Surg. 1948; 127: 269
- Surgical treatment of carotid body tumors: value of anticoagulants in carotid ligation.Ann. Surg. 1951; 133: 837
- The prevention of carotid artery hemorrhage by the use of rotating tissue flaps.Surgery. 1953; 34: 186
- Rupture of the carotids following radical neck surgery in radiated patients.Ear, Nose & Throat Monthly. 1962; 41: 531
- A muscle cover for the carotid artery after radical neck dissection.Am. J. Surg. 1961; 102: 815
© 1965 Published by Elsevier Inc.