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The Journal of Cardiovascular Surgery 1999 December;40(6):877-8

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: English

Pseudo-aneurysm of the carotid bifurcation secondary to radiation

Girishkumar H. T., Sivakumar M., Andaz S., Santosh V., Solomon R., Brown M.

From the Departments of Surgery Radiology and Oral and Facio-Maxillary Surgery Bronx-Lebanon Hospital Center, Bronx, New York


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Pseu­do­an­eu­rysms of the extra­cra­nial ­carotid ves­sels ­have a ­varied etio­path­o­gen­esis. ­Cases ­have ­been attrib­uted to spon­ta­neous rup­ture, fol­lowing ton­sil­lec­tomy or per­i­ton­sillar ­abscesses, ­trauma, post­anas­ta­motic and, ­rarely, post­ir­ra­di­a­tion, and ­ECMO. The ­authors ­present a ­case of a pseu­do­aneu­rysm ­involving the ­carotid ­artery bifur­ca­tion fol­lowing radi­a­tion ­therapy. A saph­e­nous ­vein ­graft was ­used to estab­lish con­ti­nuity ­between the ­common and the ­internal ­carotid ­arteries. A vas­cular ­shunt was ­used to main­tain cere­bral per­fu­sion ­during sur­gery. ­This ­case high­lights the tech­nical dif­fi­cul­ties encoun­tered in cor­recting ­this con­di­tion. ­This ­case exem­pli­fies the tech­nical dif­fi­cul­ties ­that are encoun­tered in a com­pli­cated ­case ­such as ­this. ­Numerous pre­vious oper­a­tions and radio­therapy com­pounded the haz­ards of the sur­gical pro­ce­dure. ­Although tech­ni­cally chal­lenging, ­every ­attempt ­must be ­made to ­resect pseu­do­an­eu­rysms ­caused by radi­a­tion ­induced vas­cular ­damage.

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