https://www.selleckchem.com/products/ff-10101.html Leaflet escape from mechanical heart valves is a rare but potentially fatal complication of prosthetic valve replacement. Historically, the incompetent valve is replaced emergently and the escaped leaflet is subsequently retrieved from its settlement in a distal vessel. If it is not retrieved, the fragment can increase the risk of infection, thrombosis, and migration. We report a case of a mechanical aortic valve leaflet that embolized during valve reoperation and caused occlusive aortic disease found 2 years later. This case emphasizes the importance of locating leaflet fragments after they are noticed missing.There are few trials assessing the risks and benefits of performing a cervical plexus block (CPB) in urgent carotid endarterectomies (CEA). We describe a case of a patient who underwent urgent CEA under CPB and suffered a complication of postoperative epiglottic hematoma. There were clinical findings that helped to distinguish the hematoma from other, more common postoperative complications. The mainstay of treatment was steroids and observation. Epiglottic hematomas after cervical blocks for CEAs are rare but potentially lethal complications. More research is needed investigating complications related to CPBs performed for CEAs.Presented is a patient with carotid artery stenosis resulting in crescendo anterior and posterior circulation transient ischemic attacks. Treatment was complicated by a rare persistent hypoglossal artery (HGA) arising from the left internal carotid artery in addition to severe contralateral carotid disease, hypoplastic vertebral arteries, and incomplete circle of Willis. A carotid endarterectomy with shunting was performed, maintaining perfusion of both the proper left internal carotid artery and HGA. This is a rare case of carotid stenosis in the setting of a persistent HGA with contralateral carotid disease and highlights the importance of planning intracranial perfusion before caro