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Updated: Aug 12, 2025

Author Spotlight: Advancing Awake Nasotracheal Intubation with Flexible Video Rhino-Laryngoscopes
Published on: August 2, 2024
Telescoping Nasal Intubation for Carotid Endarterectomy: A Case Series
Brittany J McDowell1, Sonal Sharma2
1From the Mountain West Anesthesia, Department of Anesthesiology, Intermountain Medical Center, Murray, Utah.
Abstract:
Systemic anticoagulation is a relative contraindication for performing nasal intubation due to the risk of hazardous bleeding. However, nasal intubation may sometimes be the only way to facilitate surgical exposure. There are currently no recommendations in the literature to safely perform nasal intubation in anticoagulated patients. This case series describes 4 patients, all receiving systemic anticoagulation for carotid endarterectomy, who received nasal intubation using a telescoping approach. None of them had any epistaxis. Telescoping the endotracheal tube using a red rubber catheter may be an effective and safe method for nasal intubation when there is a high risk of epistaxis.
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