Treatment of a cervical carotid pseudoaneurysm that occurred years after laryngectomy and irradiation of a neck tumor

Neurol Med Chir (Tokyo). 2011;51(8):588-91. doi: 10.2176/nmc.51.588.

Abstract

A 62-year-old man presented with rupture of a pseudoaneurysm of the left common carotid artery (CCA) that was induced after radiation therapy and neck surgery. The initial treatment was an endovascular procedure to obliterate the aneurysm with coils, and a covered stent was placed in the parent artery. However, the patient presented with subsequent coil migration, wound infection, and left CCA stenosis. Direct surgical procedures were then performed, including resection of the pseudoaneurysm with coils and stent; replacement of the carotid artery with a saphenous vein graft; and operative wound reinforcement with a pedicle flap. Endovascular treatments may be chosen for vascular diseases after irradiation, because of the low risk of wound infection and fragility of the vessels, but the long-term outcomes of intravascular treatments are still unclear. In direct surgery, dissection of the adhesive tissue and adequate wound healing are difficult. Musculocutaneous flaps with vascular pedicles can achieve good results.

Publication types

  • Case Reports

MeSH terms

  • Blood Vessel Prosthesis Implantation / adverse effects
  • Blood Vessel Prosthesis Implantation / instrumentation
  • Blood Vessel Prosthesis Implantation / methods
  • Carotid Artery Diseases / etiology
  • Carotid Artery Diseases / pathology
  • Carotid Artery Diseases / surgery*
  • Carotid Artery Injuries / etiology*
  • Carotid Artery Injuries / pathology
  • Carotid Artery Injuries / physiopathology
  • Carotid Artery Injuries / surgery*
  • Carotid Artery, Common / diagnostic imaging
  • Carotid Artery, Common / pathology
  • Carotid Artery, Common / surgery
  • Embolization, Therapeutic / adverse effects
  • Embolization, Therapeutic / instrumentation
  • Embolization, Therapeutic / methods
  • Head and Neck Neoplasms / radiotherapy
  • Head and Neck Neoplasms / surgery
  • Humans
  • Laryngectomy / adverse effects*
  • Laryngectomy / methods
  • Lymphoma / radiotherapy
  • Lymphoma / surgery
  • Male
  • Middle Aged
  • Radiography
  • Radiotherapy / adverse effects*
  • Radiotherapy / methods
  • Stents / adverse effects