[Ligation of the common carotid. Studies of the circumstances and follow up of 42 ligations].

The authors report the results of a series, between 1969 and 1978, of 42 patients who had received ligation to the carotid arterial trunk. In 36 patients, the ligation was performed as an emergency measure, often under extemporary circumstances, because of massive hemorrhage in individuals who had received surgery after previous radiotherapy. The complications after applying these ligatures have been catastrophic for many reasons. Fifteen rapid recurrent hemorrhages occurred, leading to the deaths of 13 patients. Twenty-two patients developed major neurological problems and 12 of these subsequently died. The third complication observed was the onset of extensive necrosis. This necrosis was the direct result of applying a ligature, as a last resort, to the carotid trunk supplying a vascular territory already compromised by previous radiotherapy and surgery. The authors propose different techniques for these subsequent ameliorating operations. They insist, particularly, on performing an arterectomy instead of simply applying a ligature to the carotid trunk.