Anesthetic Management of Jael Syndrome With Impacted Blade in Close Proximity to the Internal Carotid Artery: A Case Report

A A Pract. 2019 May 15;12(10):369-371. doi: 10.1213/XAA.0000000000000932.


A patient presented with a stab injury caused by a knife penetrating the orbital floor and maxillary sinus along the skull base with the tip situated adjacent to the left internal carotid artery. A flexible fiberoptic bronchoscope loaded with an endotracheal tube was initially positioned superior to the vocal cords and advanced into the trachea immediately following induction. The blade was removed after occluding endovascular balloons were positioned distal and proximal to the potential internal carotid artery injury site. Therefore, contralateral nasal fiberoptic intubation might be safely performed in patients with unilateral maxillofacial trauma, no intracranial penetration, and minimal bleeding.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Bronchoscopy / instrumentation
  • Carotid Artery Injuries / etiology*
  • Carotid Artery Injuries / surgery
  • Carotid Artery, Internal / surgery*
  • Humans
  • Intubation, Intratracheal / instrumentation*
  • Male
  • Treatment Outcome
  • Wounds, Stab / surgery*