Background: Mycotic carotid pseudoaneurysms represent a challenge for surgeons. They are rare and associated with high mortality and morbidity. Methods: We reported a case of a 61-year-old man with a mycotic pseudoaneurysm of carotid bifurcation. The case was managed by a staged procedure, starting with initial endovascular control using a stent graft, followed by open arterial reconstruction using a saphenous vein graft. Results: The patient was discharged home with a patent carotid artery and no sign of infection or bleeding. A computed tomography scan performed at 1 month, 6 months, and 1 year later confirmed good patency of the graft without imaging of cerebral ischemia. Conclusions: Mycotic pseudoaneurysms of the extracranial carotid artery are rare and should always be treated surgically. This disease, despite its rarity, requires early detection and treatment to avoid fatal outcomes. A hybrid staged approach is suggested, compared to one-staged surgery, to avoid rupture and improve clinical outcomes. This approach involves using a stent graft combined with antibiotic therapy as bridge treatment until definitive surgery can be performed to enable arterial reconstruction with an autologous graft.
Hybrid endovascular and surgical staged approach for mycotic carotid pseudoaneurysms: a case report and literature review / Marianna, Sallustro; Ilaria, Ficarelli; Teresa, Prisco; Armando, Pontarelli; Giuseppe, Foschini; Toni, Marisole; Rinaldi, Valerio; Nardi, Priscilla; Palumbo, Piergaspare; Illuminati, Giulio; Vito, D'Andrea; Ruotolo, Carlo. - In: FRONTIERS IN SURGERY. - ISSN 2296-875X. - (2024). [10.3389/fsurg.2024.1394441]
Hybrid endovascular and surgical staged approach for mycotic carotid pseudoaneurysms: a case report and literature review
Toni MarisoleMembro del Collaboration Group
;Rinaldi ValerioMembro del Collaboration Group
;Nardi Priscilla
Membro del Collaboration Group
;Piergaspare PalumboMembro del Collaboration Group
;Illuminati GiulioMembro del Collaboration Group
;Ruotolo CarloUltimo
Conceptualization
2024
Abstract
Background: Mycotic carotid pseudoaneurysms represent a challenge for surgeons. They are rare and associated with high mortality and morbidity. Methods: We reported a case of a 61-year-old man with a mycotic pseudoaneurysm of carotid bifurcation. The case was managed by a staged procedure, starting with initial endovascular control using a stent graft, followed by open arterial reconstruction using a saphenous vein graft. Results: The patient was discharged home with a patent carotid artery and no sign of infection or bleeding. A computed tomography scan performed at 1 month, 6 months, and 1 year later confirmed good patency of the graft without imaging of cerebral ischemia. Conclusions: Mycotic pseudoaneurysms of the extracranial carotid artery are rare and should always be treated surgically. This disease, despite its rarity, requires early detection and treatment to avoid fatal outcomes. A hybrid staged approach is suggested, compared to one-staged surgery, to avoid rupture and improve clinical outcomes. This approach involves using a stent graft combined with antibiotic therapy as bridge treatment until definitive surgery can be performed to enable arterial reconstruction with an autologous graft.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.