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Vol. 34. Issue 2.
Pages 75-79 (March - April 2023)
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Vol. 34. Issue 2.
Pages 75-79 (March - April 2023)
Clinical Research
Posterior cervical triangle approach for carotid endarterectomy: Technical note and results
El triángulo cervical posterior como abordaje en la endarterectomía carotídea: nota técnica y resultados
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Ignacio Arrese
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iarrese14@yahoo.es

Corresponding author.
, Santiago Cepeda, Sergio García-García, Rosario Sarabia
Unit of Vascular Neurosurgery, Hospital Universitario Río Hortega, Valladolid, Spain
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Abstract
Introduction

Carotid endarterectomy (CEA) is usually performed using the anterior cervical triangle as a surgical corridor but, when needed, the retromandibular space makes dissection of higher structures difficult in some cases. The posterior cervical triangle (PCT) can be useful in these demanding cases.

Methods

We retrospectively reviewed cases from July 2013 to November 2019 in which PCT was used as an approach for CEA. The surgical technique used was explained, and the complications and evolution of the patients were analysed.

Results

We found 7 CEAs performed through this approach, of which 2 presented transient trapezius paresis. There were no cases of severe complications in this series.

Conclusion

The PCT approach for performing CEA represents a useful and easy technique that avoids the need for mandibular mobilisation or osteotomies for lesions located in anatomically high carotid bifurcations.

Keywords:
Carotid endarterectomy
Carotid stenosis
Posterior cervical triangle
Surgical technique
Resumen
Introducción

La endarterectomía carotídea (ECA) se suele realizar utilizando el triángulo cervical anterior como corredor quirúrgico, pero el espacio retromandibular dificulta en algunos casos la disección de estructuras de localización superior. El triángulo cervical posterior (TCP) puede ser útil en estos casos complejos.

Métodos

Se ha realizado un estudio retrospectivo de los casos atendidos en nuestra unidad utilizando el TCP como abordaje en ECA desde julio de 2013 hasta noviembre de 2019. Se explica la técnica quirúrgica empleada y se han revisado las complicaciones y evolución de los pacientes.

Resultados

Se realizaron 7 ECA a través de este abordaje. Dos pacientes presentaron paresia transitoria del trapecio. No hubo casos de complicaciones graves en esta serie.

Conclusión

El abordaje por el TCP para la realización de ECA representa una técnica útil y técnicamente simple, que evita procedimientos de movilización mandibular para lesiones localizadas en bifurcaciones carotídeas anatómicamente altas.

Palabras clave:
Endarterectomía carotídea
Estenosis carotídea
Triángulo cervical posterior
Técnica quirúrgica

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