Traumatic Common Carotid Artery Transection: A Case Report of Primary Carotid Artery Repair with Survival and No Neurological Sequelae
C. C. Tang
*
Department of General Surgery, Hospital Pulau Pinang, Malaysia and Department of General Surgery, National University of Malaysia, Malaysia.
M. A. Zairul
Department of General Surgery, National University of Malaysia, Malaysia.
C. G. Yew
Department of General Surgery, Hospital Pulau Pinang, Malaysia.
*Author to whom correspondence should be addressed.
Abstract
Total transection of Common Carotid Artery is an uncommon surgical emergency in Malaysia. Although uncommon, it is frequently associated with significant neurological morbidity despite prompt successful repair and also associated with high mortality. It remained a challenge to all managing general surgeon around the country in area where vascular surgeon is hard to come by.
We present a case of traumatic common carotid artery transection with extended hours of compromised ipsilateral carotid-cerebral blood flow, but adequacy of contralateral carotid flow and intact Circle of Willis during intraoperative assessment, underwent a primary transected carotid artery repair in the event of attempted murder and successful outcome without any neurological sequelae.
This case study highlighted the importance of contralateral carotid inflow pairing with an intact Circle of Willis in determining patient’s neurological outcome for ipsilateral carotid artery transection, multidisciplinary approach for vascular injury in neck trauma, and close post-operative follow up.
Keywords: Common carotid artery transection, common carotid artery injury, common carotid artery repair, circle of willis, neck trauma, neck vascular injury