CAROTID ARTERY

- Recommendations: Repair.
- Utility of temporary shunt: High (low probability of shunt thrombosis and restores flow to the brain quickly)
- Method/Conduit: Vein patch or vein interposition graft.

Pearls

- Zone I cervical injuries are best approached with median sternotomy for ample proximal exposure.
- Early control of common carotid with umbilical tape/Rummel or DeBakey clamp.
- 3 Fr Fogarty with 3-way stopcock is useful to occlude internal carotid back bleeding.
- Shunt and augment mean arterial pressure during carotid repair to perfuse brain.
- Equipment: Weitlaner or Cerebellar self-retaining retractors, Argyle or Sundt shunts, and vascular clamps such as angled DeBakey clamp, profunda clamp, Kitzmiller clamp. Javid clamp.