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Carotid Endarterectomy Using Maneuvers to Augment Extreme Cranial Exposure
Brad S. Oriel, MD, Thomas W. Cheng, MS, Alik Farber, MD.
Boston Medical Center, Boston, MA, USA.

OBJECTIVES: To demonstrate in a case video the feasibility of accessing extremely high carotid lesions using strategic maneuvers.
METHODS: Cranial exposure of the carotid artery was maximized with the use of nasotracheal intubation, mandibular subluxation, divison of the posterior belly of the digrastic muscle and use of a table-mounted retractor.
RESULTS: Successful carotid endarterectomy for a lesion observed at the level of the C2 vertebra.
CONCLUSIONS: Carotid endarterectomy at the level of the C2 vertebra is feasible using strategic exposure maneuvers.


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