Mycotic aneurysm of the external carotid artery

Abstract

Mycotic aneurysms of the extracranial carotid arteries are extremely rare. A case is reported of a false aneurysm of the left external carotid artery. This developed secondary to cervical lymphadenitis which did not settle with high dose antibiotic therapy. The diagnosis was made on investigation with carotid doppler ultrasound and confirmed with computerized tomography. Digital subtraction angiography was performed to highlight the vascular anatomy. In addition percutaneous balloon catheter control of blood flow in the external carotid artery was used as an adjunct to surgical management.

Endovascular coiling of a mycotic external carotid artery pseudoaneurysm following pharyngolaryngectomy with a free jejunal graft

“…7 Previous irradiation may have been a contributing factor in our patient, as previous reports have linked radiation to pseudoaneurysm formation. 7 Previous irradiation may have been a contributing factor in our patient, as previous reports have linked radiation to pseudoaneurysm formation.…”

“…Reports have shown that mycotic pseudoaneurysms develop from soft tissue infections surrounding the artery, as well as from metastatic spread of infection and primary microbial arteritis 7 . Previous irradiation may have been a contributing factor in our patient, as previous reports have linked radiation to pseudoaneurysm formation 8…”

Mycotic pseudoaneurysm of common carotid artery mimicking parapharyngeal abscess

“…Where there is involvement of the common or internal carotid artery, reconstruction should be undertaken using autologous graft tissue. 1 …”

Radiology Quiz Case 2: Diagnosis

“…1 Since the introduction of antibiotic therapy, the incidence and mortality rates have greatly decreased. [2][3][4] Various pathogens have been implicated, including Staphylococcus aureus, Streptococcus, and Salmonella. 2,3,5 Pseudoaneurysms of the carotid vessels appear to be related to infection of the deep spaces of the neck, 3,4,6 particularly the parapharyngeal space, which contains important structures such as the carotid sheath and its contents, the lower 4 cranial nerves, the sympathetic chain, and the lymph nodes that drain the nose, nasopharynx, and tonsils.…”

“…2,8 More recently, endovascular occlusion has become more popular either as an adjunct to surgery or as the primary modality of treatment. [3][4][5]7,9 There is a risk of hemiplegia with endovascular techniques; therefore, it is essential that a test occlusion is carried out before embolization is performed. In most cases, there will be an adequate collateral supply because pseudoaneurysms of the carotid vessels are progressive lesions.…”