Pseudoaneurysm of the Internal Carotid Artery

Pearson, Susan E.; Choi, Sukgi S.

doi:10.1001/archotol.131.5.454

Cited by 33 publications

(15 citation statements)

References 10 publications

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“…[2] Spontaneous thrombosis can occur in small pseudoaneurysms, but it is unpredictable and less likely to occur in those greater than 1.8 cm in diameter and in the presence of continued anticoagulation. [4] In our case, smaller size of pseudoaneurysm with a short neck, early diagnosis, and withdrawal of anticoagulant were the factors that favored spontaneous thrombosis of the pseudoaneurysm.…”

Section: Discussionmentioning

confidence: 68%

“…It may result from retropharyngeal or parapharyngeal sepsis, penetrating trauma, invasion by malignancy, radiotherapy, radical neck dissection, and iatrogenic causes such as vascular surgeries, needle puncture, and tonsillectomy. [4] Clinically, ICA pseudoaneurysms present as a pulsatile lateral neck mass, medial bulge in pharyngeal wall, or as carotid thrill or bruit. CBTs are slow-growing, highly vascular tumors arising from paraganglionic cells of carotid body located in the posteromedial wall of the common carotid artery at the level of carotid bifurcation.…”

Section: Discussionmentioning

confidence: 99%

“…[4] There is only one report of ICA pseudo-pseudoaneurysm complicating CBT excision, which was proved to be a postoperative fluid collection with no demonstrable arterial flow on CT scan. [6] In our case, Color Doppler done on the first postoperative day showed dissection with partial thrombosis of ICA.…”

Section: Discussionmentioning

confidence: 99%

“…CECT or CT angiography shows an intensely enhancing mass projecting outside the confines of the arterial wall, with or without mural thrombus. [4] MRI shows flow void in a patent aneurysm and variable signal intensity in athrombosed aneurysm. The various treatment options for pseudoaneurysms include USG-guided compression, percutaneous thrombin injection, coil embolization, endovascular stent graft insertion, and surgery.…”

Section: Discussionmentioning

confidence: 99%

“…[8] Treatment failures can occur in pseudoaneurysms which are larger, multiloculated, and longstanding, with wider neck and high flow rates and in patients receiving high levels of anticoagulation. [4] However, there are no reports of USG-guided compression in ICA pseudoaneurysms, probably due to the higher risk of catastrophic rupture and thromboemboli leading to cerebrovascular events.…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Pseudoaneurysm of internal carotid artery after carotid body tumor excision

Ananthakrishnan

Rajakannu

Karthikeyan

et al. 2013

Indian Journal of Radiology and Imaging

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The common causes of pseudoaneurysms of internal carotid artery (ICA) in the neck are penetrating trauma, head and neck surgeries, carotid endarterectomies, infiltrating metastatic lymph nodes and neoplasms. We report a young male patient who presented with a swelling in left upper neck diagnosed as carotid body tumor with ultrasonography and magnetic resonance imaging. Subadventitial excision of the tumor was done. The patient developed dense right hemiplegia in the immediate postoperative period. Doppler study of neck revealed left ICA dissection with partial thrombosis of the lumen. Computed tomography of the brain revealed nonhemorrhagic left capsuloganglionic infarct and he was managed conservatively with heparin. Follow-up Doppler study done 2 weeks later revealed pseudoaneurysm of the ICA. Attempts to obliterate the pseudoaneurysm by interventional procedures failed due to the narrow neck of the pseudoaneurysm. Heparin was stopped and patient was maintained only on oral aspirin. Doppler study repeated 1 week later showed spontaneous thrombosis of the pseudoaneurysm with good flow in the distal ICA. To the best of our knowledge, only one case of pseudo-pseudoaneurysm complicating surgical resection of carotid body tumor has been reported so far The etiology, imaging features, and treatment options of pseudoaneurysms are discussed.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%