Treatment of Type Ia Endoleak Using Laser Fenestration for Placement of an Endograft to the Left Subclavian Artery

anterior border of the sternocleidomastoid muscle. Careful, but tedious, dissection was performed to avert potential injury to the surrounding nerves. Dissection of the common carotid artery was accomplished. However, distal control of the internal and external carotid arteries could not be achieved owing to the large size of the mass. Exposure of the vagus nerve at the surgical field was obtained, with the identification of the internal jugular vein and its control proximally. The mass was initially approached via its lower pole and then moved upward toward the base of the skull until the entire mass was removed (Fig 2) and sent for histopathologic examination. One week later, the contralateral carotid body tumor was also successfully resected via a similar surgical approach. Conclusions: Surgical excision of CBT with occasional preoperative embolization should be considered the only curative option, with very low morbidity and mortality when applying meticulous vascular surgical techniques. In addition, we believe that surgical treatment of bilateral CBTs should be staged.