title: Endovascular coiling of a mycotic external carotid artery pseudoaneurysm following pharyngolaryngectomy with a free jejunal graft.
abstract: OBJECTIVE
  (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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  In this patient, endovascular coiling of the external carotid artery was considered to be the only definitive treatment for a life-threatening mycotic pseudoaneurysm.
authors: Department of Ear Nose and Throat, New Cross Hospital, Wolverhampton, UK. jeremysmelt@doctors.org.uk
authors: J L C
authors: JL
authors: Smelt
authors: O
authors: O
authors: Alhamarneh
authors: J D
authors: JD
authors: Dyer
authors: L
authors: L
authors: Liew
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects; D002176:Candida albicans / Q000302:isolation & purification; D020212:Carotid Artery Injuries / Q000000981:diagnostic imaging / Q000382:microbiology / Q000628:therapy*; D002342:Carotid Artery, External / Q000473:pathology*; D004621:Embolization, Therapeutic / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods*; D006801:Humans; D007583:Jejunum / Q000637:transplantation; D007825:Laryngectomy / Q000009:adverse effects; D008297:Male; D037981:Neck Dissection / Q000009:adverse effects*; D010611:Pharyngectomy / Q000009:adverse effects; D010614:Pharynx / Q000098:blood supply / Q000601:surgery*; D011859:Radiography; D013529:Surgical Wound Dehiscence