title: Carotid Subclavian Bypass and Stent Grafting for Mycotic Pseudoaneurysm of Right Subclavian Artery.
abstract: BACKGROUND
  The occurrence of mycotic pseudoaneurysms of the subclavian artery (SA) is rare. Only 3 cases of a combined open and endovascular treatment of true SA aneurysms have been reported. Conventional treatment for SA pseudoaneurysms is invasive thoracic surgery. Ours is a novel approach for mycotic pseudoaneurysm.
  
  
  METHODS
  A 72 year-old man with gastric cancer developed vocal cord paralysis because of a mycotic pseudoaneurysm of the right SA, after Hickman line insertion. Because of the close proximity between the pseudoaneurysm at the origin of the SA and the innominate and common carotid arteries, a combined endovascular and open carotid SA bypass was performed.
  
  
  RESULTS
  At 1-year follow-up, he recovered well, remained cancer-free, with resolution of the pseudoaneurysm. Both the anastomoses and stents remained widely patent.
  
  
  CONCLUSIONS
  This case represents the first reported successful treatment of a mycotic SA pseudoaneurysm through a combined open bypass and covered stenting, with encouraging outcomes at 1-year follow-up.
authors.affiliation: Department of Vascular Surgery, Singapore General Hospital, Singapore, Singapore. Electronic address: dexter_ys_chan@nuhs.edu.sg.
authors.forename: Dexter Yak Seng
authors.initials: DY
authors.lastname: Chan
authors.affiliation: Department of Vascular Surgery, Singapore General Hospital, Singapore, Singapore.
authors.forename: Tze-Tec
authors.initials: TT
authors.lastname: Chong
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D000785:Aneurysm, Infected / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D002339:Carotid Arteries / Q000601:surgery*; D055499:Catheter-Related Infections / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D002405:Catheterization, Central Venous / Q000009:adverse effects; D057510:Endovascular Procedures / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D015607:Stents; D013274:Stomach Neoplasms / Q000188:drug therapy; D013348:Subclavian Artery / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents