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World Journal of Emergency Medicine ›› 2015, Vol. 6 ›› Issue (3): 229-232.doi: 10.5847/wjem.j.1920-8642.2015.03.013

• Case Reports • Previous Articles     Next Articles

Endovascular repair of giant traumatic pseudo-aneurysm of the common carotid artery

Yuk Law, Yiu Che Chan(), Stephen W. Cheng   

  1. Division of Vascular & Endovascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, South Wing, Queen Mary Hospital, Hong Kong, China
  • Received:2014-12-20 Accepted:2015-04-16 Online:2015-09-15 Published:2015-09-15
  • Contact: Yiu Che Chan E-mail:ycchan88@hkucc.hku.hk

Abstract:

BACKGROUND: Delayed presentation of carotid artery pseudoaneurysm following many years after self-inflicted penetrating injury of the neck is extremely rare. Open surgical carotid repair may involve sternotomy for proximal vascular control. Endovascular treatment is evolving as a less-invasive treatment option.
METHODS: We report a 55-year-old man with a history of paranoid schizophrenia who presented with a progressively enlarging left sided neck mass many years after attempted suicide. CT scan confirmed a 6 cm pseudoaneurysm arising from the common carotid artery.
RESULTS: Through an open retrograde puncture of the distal common carotid artery, the common carotid pseudoaneurysm was successfully repaired with a BARD fluency carotid stentgraft of 8 mm×80 mm (BARD, Tempe, AZ). The patient recovered well with no neurological deficits and was discharged on postoperative day 4. Dual antiplatelet agents of aspirin and clopidogrel were given for six months and then clopidogrel was administered lifelong. The neck mass decreased in size gradually and became non pulsatile upon follow-up.
CONCLUSION: Endovascular stenting of giant carotid pseudoaneurysm is an acceptable less invasive treatment option for giant carotid pseudoaneurysm. Long-term follow-up and a greater number of cases are mandatory to establish the safety of this strategy.

Key words: Carotid pseudoaneurysm, Carotid injury, Attempted suicide, Endovascular, Stentgrafts