Carotid Endarterectomy for High Plaque
High plaque in a patient undergoing carotid endarterectomy is defined as extending to the level of second cervical vertebral body. In majority of cases, high plaque can be diagnosed by CT angiography of the neck. Distal exposure of the internal carotid artery is facilitated by division of sternocleidomastoid branch of occipital or occipital artery itself and division of post belly of digastric and stylohyoid muscle. Mandibular subluxation to obtain distal exposure of ICA may be necessary. There is higher incidence of cranial nerve palsy in patients undergoing CEA for high plaque.
KeywordsPost belly digastric Styloid process Occipital artery Mandibular subluxation
- Berguer R. Operations on the internal carotid artery in function and surgery of the carotid and vertebral arteries. Dordecht: Wolters Kluwer; 2014. p. 90–119.Google Scholar