ABSTRACT
A 2-0 silk looped Potts tie is placed around the superior thyroid artery to control backbleeding. I take this tie up and hang it over the vertically oriented Weitlaner retractor with a snap on the end of the silk to occlude the vessel. On occasion, accessory ECA branches such as the ascending pharyngeal may be identified on the angiogram and these also need to be isolated with a separate encircling silk suture. It is crucial that all potential sources of backbleeding be identified and controlled before opening the carotid artery since even minor backbleeding will obscure the lumen enough to make shunt placement significantly more difficult.
