Surgicel Mimicking Acute Vessel Occlusion after Carotid Endarterectomy: A Case Report. Issue 2 (June 2014)

• Record Type: Journal Article
• Authors: Morris, Rhys; Bosanquet, David C.; Mapstone, Julia; James, Dorrien; Fligelstone, Louis
• Is Part Of: Journal for vascular ultrasound. Volume 38:Issue 2(2014)
• Page Start: 87
• Page End: 88
• Publication Date: 2014-06
• Subjects: Cardiovascular system -- Diseases -- Diagnosis -- Periodicals; Cardiovascular system -- Diseases -- Ultrasonic imaging -- Periodicals; Electronic journals; Periodicals; 616.1307543
• DOI: 10.1177/154431671403800204
• Languages: English
• ISSNs: 1544-3167

Abstract

Surgicel (oxidized regenerated cellulose; Ethicon, Somerville, NJ) is widely used in surgery to achieve hemostasis but can interfere with postoperative imaging. A patient was noted to have lateralizing neurologic deficits immediately after a carotid endarterectomy, with an internal carotid artery flow void on duplex. However, at return to the operating theater, no flow void was noted after Surgicel was removed. Reapplying Surgicel around the vessel recreated this acoustic shadow, confirming this ultrasonographic finding was simply an artifact. Surgicel is known to trap air within the interstices of the gauze. This phenomenon can obscure vessel flow to mimic an occlusion on duplex imaging.