case_images: PMC9935701_01
case_images: Case 1: (A) coronal CT of the neck showed massive blood clots around the left carotid artery, which compressed and displaced the trachea. Note: the red circle is marked in the left carotid sheath. (B) Intraoperative exploration of left common carotid artery amputation. Note: the arrow is marked as the broken end of the left common carotid artery. (C) Place the image of an artificial vascular anastomosis. Note: the arrow is marked after artificial vascular implantation. (D) Three-dimensional postoperative computer tomographic scan showing a clogged left carotid. Note: the arrow points to the broken end of the left common carotid artery.
case_images: fsurg-09-1082658-g001.jpg
case_images: PMC9935701_01_fsurg-09-1082658-g001.jpg
case_images: F1
case_images: CT scan (Figure 1A) indicated soft tissue swelling, gas accumulation in the neck, and massive blood clots around the left carotid artery which compressed and displaced the trachea. After an approximately 1-cm resection of the irregular stumps, end-to-end anastomosis was no longer possible (Figure 1B). Thus, the insertion of an interposition polytetrafluoroethylene (PTFE) graft (Figure 1C) was performed to reconstruct the CCA, and the patient was transferred to the ICU after the operation. Two weeks after discharge, CT angiography (CTA) showed that blood flow was absent at the site of the PTFE graft but present in the internal and external carotid arteries above the bifurcation, these arteries being thinner than their counterparts on the opposite side (Figure 1D).
case_images: PMC9935701_02
case_images: Case 2: (A) the left common carotid artery that was severed from the proximal end of the heart and prolapsed at the time of treatment. Note: the arrow points to the left common carotid artery. The triangle points to the distal end of the left common carotid artery. The cervical CT coronal (B) and sagittal (C) images showed that the origin of the left common carotid artery was not shown, the contrast filling was not seen in the distance, and the structure was not clearly displayed. Note: the arrow refers to the beginning of the left common carotid artery. (D) The left common carotid artery was not seen at the CT level of the neck. Note: the arrow refers to the location of the left common carotid artery. (E) Normal development of the left common carotid artery at the level of the CT in the neck. Note: the arrow refers to the left common carotid artery.
case_images: fsurg-09-1082658-g002.jpg
case_images: PMC9935701_02_fsurg-09-1082658-g002.jpg
case_images: F2
case_images: During the operation, the left CCA was identified to be completely transected with approximately 6 cm of the distal end exposed on the wound surface (Figure 2A). C; heart rate 75 beats per minute; blood pressure 95/61 mmHg; respiratory rate 12/min; and fingertip oxygen saturation 100%. Contrast CT scan further identified the CCCAT according to the proximal stump of the CCA and the absence of the prograde blood flow through the CCA (Figures 2B-E).