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Invited Commentary |

More Questions Than Answers in 6 Cases

Jeffrey E. Indes, MD1,2; Alan Dardik, MD, PhD1,2
[+] Author Affiliations
1Department of Surgery, Section of Vascular Surgery, Yale University School of Medicine, New Haven, Connecticut
2VA Connecticut Healthcare Systems, West Haven
JAMA Surg. 2013;148(11):1067. doi:10.1001/jamasurg.2013.3791.
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Bechara and colleagues1 report a series of 12 patients treated over 11 years who sustained intraoperative carotid artery introducer sheath placement during attempted jugular vein cannulation. Six earlier patients were treated with open carotid artery exploration and primary repair, whereas the more recent 6 patients were treated with percutaneous closure using a suture-mediated closure device. No patients in either group had neurological events or other complications. However, the mean duration of treatment was shorter in the endovascular group than the operative group, 6 vs 32 minutes, respectively. The authors conclude that endovascular closure is as safe and effective as operative repair but more expeditious.

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