Endoscopic repair of an injured internal carotid artery utilizing femoral endovascular closure devices

Van Rompaey, Jason, Bowers, Greg, Radhakrishnan, Jay, Panizza, Benedict and Solares, C. Arturo (2014) Endoscopic repair of an injured internal carotid artery utilizing femoral endovascular closure devices. Laryngoscope, 124 6: 1318-1324. doi:10.1002/lary.24403

Author Van Rompaey, Jason
Bowers, Greg
Radhakrishnan, Jay
Panizza, Benedict
Solares, C. Arturo
Title Endoscopic repair of an injured internal carotid artery utilizing femoral endovascular closure devices
Journal name Laryngoscope   Check publisher's open access policy
ISSN 0023-852X
Publication date 2014-01-29
Year available 2014
Sub-type Article (original research)
DOI 10.1002/lary.24403
Volume 124
Issue 6
Start page 1318
End page 1324
Total pages 7
Place of publication Hoboken, NJ, United States
Publisher John Wiley & Sons
Collection year 2015
Language eng
Formatted abstract
Objectives/Hypothesis: Injury to the internal carotid artery is a feared complication of endoscopic endonasal surgery of the skull base. Such an event, although rare, is associated with high morbidity and mortality. Even if bleeding is controlled, permanent neurological defects frequently persist. Many techniques have been developed to manage internal carotid artery rupture with varying degrees of success. The purpose of this study was to explore endoscopic management of arterial damage with endovascular closure devices used for a femoral arteriotomy. The ability to remotely suture a damaged artery permits the possible adaptation of this technology in managing endoscopic arterial complications.

Study Design: Technical note.

Methods: After the creation of an endoscopic endonasal corridor in a cadaveric specimen, an arteriotomy was created at the cavernous portion of the internal carotid artery. The Angio-Seal, StarClose, and MynxGrip vascular closure devices were utilized under endoscopic guidance to repair the arteriotomy. Angiography was then done on a cadaver sutured with the

Results: Both the Angio-Seal and StarClose were deployed quickly and appeared to provide sufficient closure of the arteriotomy. The Angio-Seal required the use of a guidewire and was longer to deploy when compared with the StarClose. The StarClose deployment was quick and facile. The MynxGrip also deployed without difficulty.

Conclusions: The Angio-Seal and StarClose systems were both successfully deployed utilizing an endoscopic endonasal approach. The MynxGrip was the easiest to deploy and has the greatest potential to be of benefit in this application. Further studies with hemodynamic models are required to properly assess the appropriateness in this setting.
Keyword Arteriotomy
Internal carotid artery rupture
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online ahead of print 29 January 2014.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 3 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 3 times in Scopus Article | Citations
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Created: Sat, 25 Jan 2014, 13:06:20 EST by Dr Benedict Panizza on behalf of Surgery - Princess Alexandra Hospital