title: Adjunctive endovascular techniques in the management of postoperative carotid artery pseudoaneurysms--useful armamentarium for vascular surgeons--three case reports.
abstract: Postoperative carotid artery pseudoaneurysms are rare. The traditional treatment of choice has been operative repair, which can present a significant technical challenge owing to the reoperative neck inflammation and potential cranial nerve injuries. The authors report 3 cases of postoperative carotid pseudoaneurysms that were successfully managed by use of various adjunctive endovascular techniques. The adjunctive endovascular maneuvers included the following: 1) endoluminal balloon placement for preoperative test occlusion and intraoperative proximal control to facilitate operative dissection in the first patient with a carotid pseudoaneurysm; 2) endoluminal stent-graft placement to exclude a large expanding carotid pseudoaneurysm in the second patient; and 3) endoluminal coil placement along with balloon occlusion to achieve complete hemostasis in the third patient, who presented with a hemorrhaging carotid pseudoaneurysm. Successful outcomes were achieved in all 3 patients by use of adjunctive endovascular techniques. These cases underscore the role of adjunctive endovascular treatment as an armamentarium for vascular surgeons in the treatment of complex carotid pseudoaneurysms.
authors.affiliation: Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Thomas T
authors.initials: TT
authors.lastname: Terramani
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Workman
authors.forename: Zeev
authors.initials: Z
authors.lastname: Loberman
authors.forename: David L
authors.initials: DL
authors.lastname: Dawson
authors.forename: Ruth L
authors.initials: RL
authors.lastname: Bush
authors.forename: Alan B
authors.initials: AB
authors.lastname: Lumsden
authors.forename: Peter H
authors.initials: PH
authors.lastname: Lin
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000209:etiology / Q000628:therapy*; D002340:Carotid Artery Diseases / Q000628:therapy*; D002404:Catheterization; D016894:Endarterectomy, Carotid / Q000009:adverse effects*; D005260:Female; D006488:Hemostasis, Surgical; D006801:Humans; D008297:Male; D012501:Saphenous Vein / Q000637:transplantation; D015607:Stents; D014656:Vascular Surgical Procedures