Radial Artery Graft for Giant Common Carotid Artery Pseudoaneurysm After Carotid Artery Stenting

Matano, Fumihiro; Suzuki, Masanori; Mizunari, Takayuki; Yamada, Toshimasa; Murai, Yasuo; Morita, Akio

doi:10.1016/j.wneu.2020.04.173

Cited by 4 publications

(7 citation statements)

References 18 publications

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“…[16] During our search, and excluding trauma and cancer blowout cases, we found only six case reports to date [Table 1]. [4,7,11,19,21,29] In our case as well as these six cases, all patients were male and relatively older adult, with a median age of 78 (49-88). In general, men are more susceptible to infections caused by viruses, bacteria, parasites, and fungi than women, [14] and individuals become more immunocompromised as they age.…”

Section: Discussionmentioning

confidence: 83%

“…In the previous reports, authors discussed some potential causes of carotid stent infections. [7,11,19,21,29] Son et al reported that phlebitis of the forearm and septicemia preceded the appearance of neck swelling. [29] Dental surgery and septic teeth in the oral cavity have also preceded neck swelling.…”

Section: Discussionmentioning

confidence: 99%

“…[7,19] Matano et al presumed that iatrogenic intimal arterial wall injury during endovascular thrombectomy and CAS followed by septicemia caused bacterial attachment to the injured arterial wall and stent. [21] Kaviani et al placed a CAS for a patient who had undergone radical neck dissection for a carcinoma followed by neck irradiation. Erosion of the metallic stent through the dermis because of the paucity of soft-tissue coverage and the inherent functional abnormality of the irradiated dermis were thought to have caused the stent infection.…”

Section: Discussionmentioning

confidence: 99%

“…ese infections often cause arterial destruction and pseudoaneurysm formation. [4,7,11,19,21,29,30] Treatment through stent removal and aneurysm resection with reconstruction using saphenous vein (SV) [7,11,29] and radial artery (RA) grafts [21] have been reported. We report a case of stent infection with pseudoaneurysm formation 3 months after CAS that was treated by replacing the infected stent and pseudoaneurysm with a polytetrafluoroethylene (PTFE) synthetic vessel graft.…”

Section: Introductionmentioning

confidence: 99%

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Stent infection and pseudoaneurysm formation after carotid artery stent treated by excision and in situ reconstruction with polytetrafluoroethylene graft: A case report

Nishizawa

Ozaki

Kidani

et al. 2022

Surgical Neurology International

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Background: Stent infection after carotid artery stenting (CAS) can be a life-threatening postoperative complication, but there is a paucity of data due to its exceedingly low frequency. We report a case of stent infection with pseudoaneurysm formation after CAS that was treated through replacing the infected stent and pseudoaneurysm with a polytetrafluoroethylene (PTFE) synthetic vessel graft. Case Description: An 86-year-old man was treated for the right internal carotid artery with CAS in local hospital. One month after stenting, he suffered aspiration pneumonia and septicemia. Three months after stenting, swelling and tenderness of the right side of his neck appeared. His general condition deteriorated due to septicemia and he was unable to ingest anything by mouth as a result of decreasing levels of consciousness. He was transferred to our hospital. Computed tomography and digital subtraction angiography showed the presence of a pseudoaneurysm around the stent. The neck mass enlarged daily and surgical intervention was required to prevent closure of the airway. Stent and pseudoaneurysm resection and in situ reconstruction with a PTFE synthetic vessel graft were performed. The patient returned to his local hospital 36 days after surgery and had a modified Rankin Score of 5. Conclusion: Although the risk of reinfection is high due to the nature of artificial material, stent/pseudoaneurysm resection and in situ reconstruction with a PTFE synthetic vessel graft might be one of the best options for patients suffering stent infection after CAS. To the best of our knowledge, this is the first report of treatment using this material.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Stent infection and pseudoaneurysm formation after carotid artery stent treated by excision and in situ reconstruction with polytetrafluoroethylene graft: A case report

Nishizawa

Ozaki

Kidani

et al. 2022

Surgical Neurology International

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“…Several groups have advocated usage of autologous femoral and radial artery in reconstruction of common carotid artery. 5 Endovascular interventions are being increasing used in the management of neck pseudoaneurysm. The aim of any treatment modality will be to protect cerebral perfusion, prevent pseudoaneurysm rupture, and correct etiology.…”

Section: Discussionmentioning

confidence: 99%

Challenges in Managing Massive Neck Pseudoaneurysm

Bharath

Agasty

Hote

2021

Journal of Cardiac Critical Care TSS

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Pseudoaneurysms in the neck are challenging surgical cases. They need detailed preoperative evaluation, treatment of etiology, and surgical/interventional management at appropriate time.Here, we describe a case of 45-year-old female who presented to emergency with impending rupture of swelling in the right side of neck. On evaluation, it was found to be a pseudoaneurysm of right common carotid artery (RCCA). She was planned for emergency surgery, but the swelling ruptured before the patient could be taken into the operation room (OR). The challenges faced in managing it are described below.

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Editor's Choice – European Society for Vascular Surgery (ESVS) 2023 Clinical Practice Guidelines on the Management of Atherosclerotic Carotid and Vertebral Artery Disease

Naylor¹,

Rantner²,

Ancetti³

et al. 2023

European Journal of Vascular and Endovascular Surgery

391

219

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Radial Artery Graft for Giant Common Carotid Artery Pseudoaneurysm After Carotid Artery Stenting

Cited by 4 publications

References 18 publications

Stent infection and pseudoaneurysm formation after carotid artery stent treated by excision and in situ reconstruction with polytetrafluoroethylene graft: A case report

Stent infection and pseudoaneurysm formation after carotid artery stent treated by excision and in situ reconstruction with polytetrafluoroethylene graft: A case report

Challenges in Managing Massive Neck Pseudoaneurysm

Editor's Choice – European Society for Vascular Surgery (ESVS) 2023 Clinical Practice Guidelines on the Management of Atherosclerotic Carotid and Vertebral Artery Disease

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