Prophylactic ligation of proximal of common carotid artery under local anesthesia for carotid artery rupture

Abstract

Carotid artery rupture is a catastrophic complication in the treatment of head and neck cancer, and is associated with a mortality of 〜40％. We have experienced two cases in which a good prognosis was achieved by performing ligation of the common carotid artery under local anesthesia to patients with a high risk of carotid artery rupture at the terminal stage. In both cases, only the proximal side of the common carotid artery was ligated. The surgery is performed under local anesthesia: the common carotid artery is clamped for 10 minutes during the surgery, and while observing the response of the patient himself, ligation is performed after confirming that there is no appearance of cerebrovascular disorder. CT after surgery showed thrombosis of the common carotid artery and internal carotid artery and the carotid artery did not collapse. Meanwhile, the appearance of cerebrovascular disorder was not observed, and the patients were able to leave the hospital early and live a meaningful life at home.