title: Mycotic Aneurysm of the Extracranial Internal Carotid Artery, Resect and Ligate or Reconstruct?
abstract: Mycotic aneurysmal disease of the extracranial carotid arteries (ECA) is a rare entity associated with a high morbidity, including rupture, hemorrhage, airway obstruction, and stroke. Surgical management is challenging due to difficult dissection through infected or inflamed tissue. This report highlights a case of ECA-aneurysm infection presenting with stroke and an occluded internal carotid artery, likely due to microbial arteritis on a background of osteomyelitis. Operative intervention was performed to definitively treat the infection and prevent the potential associated complications. In this case, the incident vessel was 100% occluded at presentation, allowing vessel ligation and resection without carotid complex reconstruction.
authors.affiliation: Department of Vascular Surgery, University Hospital Waterford, Waterford, Ireland.
authors.forename: Ailín C
authors.initials: AC
authors.lastname: Rogers
authors.affiliation: Department of Vascular Surgery, University Hospital Waterford, Waterford, Ireland.
authors.forename: Michael
authors.initials: M
authors.lastname: Bourke
authors.affiliation: Department of Vascular Surgery, University Hospital Waterford, Waterford, Ireland.
authors.forename: Adam S
authors.initials: AS
authors.lastname: Galbraith
authors.affiliation: Department of Vascular Surgery, University Hospital Waterford, Waterford, Ireland.
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Ryan
authors.affiliation: Department of Vascular Surgery, University Hospital Waterford, Waterford, Ireland.
authors.forename: K Simon C
authors.initials: KS
authors.lastname: Cross
authors.affiliation: Department of Vascular Surgery, University Hospital Waterford, Waterford, Ireland. Electronic address: morgan.mcmonagle@hse.ie.
authors.forename: Morgan P
authors.initials: MP
authors.lastname: McMonagle
mesh_terms: D000785:Aneurysm, Infected / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D002533:Cerebral Angiography / Q000379:methods; D000072226:Computed Tomography Angiography; D006801:Humans; D008026:Ligation; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000295:instrumentation; D013203:Staphylococcal Infections / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D007507:Therapeutic Irrigation; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents