An aid to accessing the distal internal carotid artery

Accessing the distal internal carotid artery can be a challenge to even the most experienced vascular surgeon. In most patients, the need for distal exposure can be anticipated in advance, thereby enabling the surgeon to consider simple measures, such as nasolaryngeal intubation, or more complex interventions, such as temporomandibular subluxation, to facilitate access. Once the procedure is underway, however, neither of these strategies can be used. The advantage of the approach described in this article is that it can be used at any time during the operation.