title: Hybrid endovascular and surgical approach for mycotic pseudoaneurysms of the extracranial internal carotid artery.
abstract: OBJECTIVE
  Mycotic pseudoaneurysms of the extracranial internal carotid artery are rare, and their management often represents a challenge, but treatment is necessary due to the high risk of rupture and distal brain embolization. Systemic antibiotics associated with open surgical excision of the infected tissues and carotid reconstruction using autologous grafts are the treatment of choice. The use of endovascular techniques still remains controversial in infective fields; however, it can be an attractive alternative in high-risk patients or more often as a "temporary" solution to achieve immediate bleeding control for a safe surgical reconstruction.
  
  
  METHODS
  We discuss the unusual case of an extracranial right internal carotid artery mycotic pseudoaneurysm following methicillin-resistant Staphylococcus aureus infection, in a patient with poor general conditions.
  
  
  CONCLUSIONS
  The lesion was successfully treated using a hybrid endovascular and surgical procedure.
authors.affiliation: Operative Unit of Vascular Surgery, First Division, University of Milan, IRCCS Policlinico San Donato, Milan, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Mazzaccaro
authors.affiliation: Operative Unit of Vascular Surgery, First Division, University of Milan, IRCCS Policlinico San Donato, Milan, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Stegher
authors.affiliation: Operative Unit of Vascular Surgery, First Division, University of Milan, IRCCS Policlinico San Donato, Milan, Italy.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Occhiuto
authors.affiliation: Operative Unit of Vascular Surgery, First Division, University of Milan, IRCCS Policlinico San Donato, Milan, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Malacrida
authors.affiliation: Operative Unit of Vascular Surgery, First Division, University of Milan, IRCCS Policlinico San Donato, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Righini
authors.affiliation: Operative Unit of Vascular Surgery, First Division, University of Milan, IRCCS Policlinico San Donato, Milan, Italy.
authors.forename: Domenico G
authors.initials: DG
authors.lastname: Tealdi
authors.affiliation: Operative Unit of Vascular Surgery, First Division, University of Milan, IRCCS Policlinico San Donato, Milan, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Nano
keywords: Mycotic pseudoaneurysms; hybrid treatment; internal carotid artery