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Postoperative wound hematoma is a potentially lethal complication of carotid endarterectomy (CEA). The hematoma can rapidly distort airway anatomy, making tracheal intubation difficult and ultimately causing fatal airway obstruction. Post-CEA patients might develop airway emergencies related to hematoma formation either in the hospital or after discharge.
In a retrospective study of 3225 patients who underwent CEA during a 10-year period at a single institution, researchers identified 44 patients (1.2%) who required neck exploration for hematoma. Of these patients, 2 developed the hematoma before postoperative extubation, and the remaining 42 required reintubation. Fiber-optic tracheal intubation was the initial method attempted in 20 patien…