Endoscopic Repair of Carotid Artery Injury

Background: Injury to the cavernous portion of the Internal Carotid Artery (ICA) during endoscopic skull base surgery is a well-recognized rare complication, which can be associated with high rates of morbidity and mortality. Many techniques have been suggested to manage ICA injury with varying degrees of success. A detailed technical description of an operative technique for endoscopic management of carotid artery injury is provided. Methods: A case of ICA injury during endoscopic skull base surgery is presented. The immediate treatment measurements include: 1) early recognition of ICA injury; 2) briefing of the team and preparations; 3) packing; 4) harvesting of temporalis muscle patch; 5) placement of the muscle patch over the defect; 6) gentle compression for 10 minutes. Results: The technique presented facilitates quick repair, restoring normal blood flow through the damaged artery and thereby preventing exsanguination or the symptoms of stroke that may occur from prolonged occlusion of the ICA. Conclusions: This protocol has been useful for the management of this life-threatening complication.