Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-27T12:51:14.890Z Has data issue: false hasContentIssue false
  • English
  • Français

Endovascular coiling of a mycotic external carotid artery pseudoaneurysm following pharyngolaryngectomy with a free jejunal graft

Published online by Cambridge University Press:  18 October 2011

J L C Smelt ,
O Alhamarneh ,
J D Dyer  and
L Liew
J L C Smelt*
Affiliation:
Department of Ear Nose and Throat, New Cross Hospital, Wolverhampton, UK
O Alhamarneh
Affiliation:
Department of Ear Nose and Throat, New Cross Hospital, Wolverhampton, UK
J D Dyer
Affiliation:
Department of Radiology, New Cross Hospital, Wolverhampton, UK
L Liew
Affiliation:
Department of Ear Nose and Throat, New Cross Hospital, Wolverhampton, UK
*
Address for correspondence: Mr J L C Smelt, 2 Horwood Road, Nailsea, Bristol, BS48 2LN, UK E-mail: jeremysmelt@doctors.org.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

(1) To highlight the significance of carotid artery pseudoaneurysm as a rare complication following neck dissection, and (2) to suggest endovascular coiling as management, in the presence of infection, previous radiotherapy and a grafted blood supply.

Case report:

A 66-year-old man diagnosed with squamous cell carcinoma of the hypopharynx and upper oesophagus underwent pharyngolaryngectomy with reconstruction of a neo-pharynx using a free jejunal graft. The patient had previously received radiotherapy for a soft palate squamous cell carcinoma. Two months after surgery, computed tomography demonstrated a bilobed pseudoaneurysm of the left external carotid artery just distal to the arterial branch supplying the jejunal graft. This mycotic pseudoaneurysm was successfully treated with endovascular coiling, while maintaining the patency of the superior thyroid artery supplying the jejunal graft anastomosis.

Conclusion:

In this patient, endovascular coiling of the external carotid artery was considered to be the only definitive treatment for a life-threatening mycotic pseudoaneurysm.

Keywords

PseudoaneurysmFalse/Mycotic AneurysmTherapeutic EmbolizationCarotid ArteryLaryngectomyPharyngectomyTissue Graft
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 2 , February 2012 , pp. 214 - 216
Copyright
Copyright © JLO (1984) Limited 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Garino, JP, Ryan, TJ. Carotid haemorrhage: a complication of peritonsillar abscess. Am J Emerg Med 1987;5:220–3Google Scholar
2Schwartz, ML, Fisher, R, Sako, Y, Castaneda, AR, Grage, TB, Nicoloff, DM. Post-traumatic aneurysms of the thoracic aorta. Surgery 1975;78:589–93Google Scholar
3Baril, DT, Ellozy, SH, Carroccio, A, Patel, AB, Lookstein, RA, Marin, ML. Endovascular repair of an infected carotid artery pseudoaneurysm. J Vasc Surg 2004;40:1024–7CrossRefGoogle ScholarPubMed
4Biggs, KL, Chiou, AC, Hagino, RT, Klucznik, RP. Endovascular repair of a spontaneous carotid artery dissection with carotid stent and coils. J Vasc Surg 2004;40:170–3CrossRefGoogle ScholarPubMed
5Osler, W. The Gulstonian Lectures on malignant endocarditis. Br Med J 1885;1:467–70CrossRefGoogle ScholarPubMed
6Goddard, AJ, Lenthall, RK, Bradley, PJ. Endovascular management of infected carotid artery pseudoaneurysm complicating pharyngolaryngectomy: complete occlusion followed by early recurrence and rebleeding. J Laryngol Otol 2004;118:991–5CrossRefGoogle ScholarPubMed
7Worley, GA, Hern, JD, O'Sullivan, GJ, Tassone, P, Hinton, AE. Mycotic aneurysm of the external carotid artery. J Laryngol Otol 1998;112:793–5Google Scholar
8Girishkumar, HT, Sivakumar, M, Andaz, S, Santosh, V, Solomon, R, Brown, M. Pseudoaneurysm of the carotid bifurcation secondary to radiation. J Cardiovasc Surg 1999;40:877–8Google Scholar