Common Carotid Artery (CCA) pseudoaneurysms are uncommon vascular lesions. They are most likely to occur as a sequelae of previous neck surgery (CEA incidence <1%), blunt or penetrating injuries to the neck, cancer with radiation necrosis, iatrogenic, mycotic and fibromuscular dysplasia than spontaneously. Formation of CCA pseudoaneurysm post CEA can occur anytime from 2 days to 22 years and is attributed to wound dehiscence, suture failure, and arterial wall breakdown resulting from infection and the quality of the graft. We report the case of a neurologically asymptomatic 75-year-old male who developed an impressive, pulsatile pseudoaneurysm of the Right CCA 1 year after having bilateral CEA. There was less deliberation in his management options for he was referred to us by his General Vascular Surgeon. Angiograms revealed a 20.3 mm × 27.8 mm RCCA pseudoaneurysm that was rendered impotent using selective catherization with stent and coil embolization. Two weeks after discharge, he returned with a ruptured RCCA pseudoaneurysm and extravasations of blood through his previous incision site (CEA). New angiograms not only confirmed the stability of the 2 week old coils and stent construct but revealed a patent flow area inferior to the coils and posterior to the stent. This was again managed endovascularly using more coiling. Complete control of the pseudoaneurysm without any hemodynamic compromise was achieved and the patient was discharged home neurologically intact with no signs of infection. After 1 week, he returned with active pulsatile recalcitrant hemorrhage. This life threatening exsanguination was controlled by sacrificing the Right CCA (Parent Artery Sacrifice) after performing a Balloon Test Occlusion. This case brings to light an uncommon pathology, the complexity of its management, endovascular vs open surgical options, and the futile but systemic attempt to spare the parent artery.Competing interestsNone.Abstract E-058 Figure 1Abstract E-058 Figure 2

Spinal arteriovenous malformations are uncommon lesions that present with a constellation of nonspecific symptoms eluding most clinicians. They comprise 3%–16% of all compressive spinal cord lesions and are attributed to 30% of idiopathic myelopathies. They are most often diagnosed on imaging by a neuroradiologist. They can present with symptoms of myelopathy and radiculopathy mimicking a plethora of pathologies. We report the case of a 79-year-old female who presented with back pain and a left foot drop. MRI suggested edema in the conus medullaris and a spinal angiogram revealed serpiginous enhancement from T11-L1 consistent with a type I AVM (Dural AV fistula). She eventually underwent successful embolization after a super selective WADA test with complete occlusion of the Spinal AV fistula.Competing interestsNone.Abstract E-057 Figure 1