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FASCICOLI E ARTICOLI   I PIÙ LETTI   eTOC

ULTIMO FASCICOLOTHE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica

Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632

Periodicità: Bimestrale

ISSN 0021-9509

Online ISSN 1827-191X

 

The Journal of Cardiovascular Surgery 1999 Giugno;40(3):429-33

VASCULAR PAPERS 

 CASE REPORTS

Double ­layered autog­e­nous ­vein ­graft ­patch recon­struc­tion of the ­common ­carotid-internal jug­ular fis­tula ­caused by gun­shot ­wound

Kaklikkaya I., Ozcan F., Kutlu N.*

From the Depart­ment of Tho­racic and Car­di­o­vas­cular Sur­gery * Depart­ment of ­Plastic and Recon­struc­tive Sur­gery Karad­eniz Tech­nical Uni­ver­sity, ­Faculty of Med­i­cine
­Trabzon, ­Turkey

Hereby ­we present a ­case ­with a ­common ­carotid-­internal jug­ular fis­tula ­caused by gun­shot ­wound. The ­patient was a 32-­year old ­male who had an ­entrance ­hole of a ­bullet on his ­right ante­rior cer­vical ­area, at the C4 ­level ­with a ­hematoma sur­rounding it. The ­exit ­hole ­could be ­detected at the sub­lin­gual ­area. By pal­pa­tion a ­thrill and on aus­cul­ta­tion a ­souffle was ­noted. Nei­ther crep­i­ta­tion, nor any neu­ro­logic def­icit or any ­symptom of ­Horner’s syn­drome was ­present. The emer­gency dig­ital sub­trac­tion angio­graphy (DSA) ­showed a fis­tul­isa­tion to ­internal jug­ular ­vein (IJV) approx­i­mately 0.5 cm ­below the ­common ­carotid ­artery (CCA) bifur­ca­tion ­level. ­During the oper­a­tion a ­hematoma and a ­false aneu­rysm was ­observed on the CCA. ­Also, prox­i­mally to the bifur­ca­tion, a com­mu­ni­ca­tion of CCA ­with IJV was ­noted. The ­wall of the JJV was ­rather ­thinned and the ­size of the ­vessel had con­sid­er­ably ­enlarged. Fol­lowing the evac­u­a­tion of the ­hematoma and debride­ment, the inte­gra­tion of the ­artery was ­achieved by ­placing a ­double ­layered autog­e­nous ­vein ­graft ­patch ­over the 0.5×1.5 cm ­defect. The 0.3×1.5 cm ­defect lat­er­ally ­over the IJV was pri­marily ­sutured. The ­patient was dis­charged on the ­fifth day. The con­trol DSA ­taken on the ­twelfth day ­showed a per­fect inte­gra­tion of the ves­sels. We con­sid­ered the ­case notice­able due to its ­rather ­rare inci­dence and the ­double ­layered ­autogen ­vein ­patch ­graft recon­struc­tion.

lingua: Inglese


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