What are the possible postoperative bleeding and respiratory complications of carotid endarterectomy (CEA)?

Updated: Oct 24, 2019
  • Author: Sonia Nhieu, MD; Chief Editor: Sheela Pai Cole, MD  more...
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Answer

Answer

Airway obstruction due to an enlarging neck hematoma after CEA is rare but potentially fatal. In the early postoperative period, patients complaining of unusual neck discomfort warrant special attention. Wound hematomas after CEA are relatively common, but fortunately, the majority are small and cause no problems. In NASCET, wound hematomas were documented in 5.5% of the patients and thus were a more common complication than a major stroke or death. [1]

For large hematomas or those that continue to expand and result in airway loss or respiratory compromise, emergency treatment is indicated. If there is no airway compromise, the patient should return to the OR for emergency hematoma evacuation. However, if the airway is already obstructed by the hematoma, opening of the wound at the bedside is warranted.


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