Posterior cervical triangle approach for carotid endarterectomy: Technical note and results

Area of Science:

• Vascular Surgery
• Cervical Anatomy
• Surgical Approaches

Background:

• Traditional carotid endarterectomy (CEA) often utilizes the anterior cervical triangle.
• Dissection of higher carotid structures can be challenging via standard approaches.
• The retromandibular space may present difficulties for accessing superior lesions.

Purpose of the Study:

• To evaluate the utility of the posterior cervical triangle (PCT) as a surgical corridor for CEA.
• To assess the feasibility and safety of the PCT approach for challenging carotid bifurcations.

Main Methods:

• Retrospective review of 7 carotid endarterectomies (CEA) performed using the PCT approach.
• Data collected from July 2013 to November 2019.
• Analysis of surgical technique, patient complications, and outcomes.

Main Results:

• Seven CEAs were successfully performed utilizing the PCT approach.
• Two patients experienced transient trapezius paresis.
• No severe complications were recorded in this series.

Conclusions:

• The PCT approach is a viable and straightforward technique for CEA.
• It effectively addresses lesions at high carotid bifurcations without requiring mandibular mobilization.
• This method avoids the need for osteotomies, simplifying the surgical procedure.