Extracranial internal carotid artery pseudoaneurysms after kinking reconstruction

Area of Science:

• Vascular Surgery
• Infectious Disease

Background:

• Internal carotid artery (ICA) kinking can necessitate surgical reconstruction.
• Infected false aneurysms are a rare but significant complication following such procedures.

Observation:

• A patient developed bilateral ICA pseudoaneurysms 5-6 years after reconstruction for kinking.
• Symptoms included dizziness, vertigo, and neck masses.
• Diagnostic imaging revealed bilateral pseudoaneurysms.

Findings:

• Surgical resection of the aneurysmal sac followed by end-to-end arterial reconstruction was performed.
• Postoperative wound swabs confirmed Staphylococcus aureus infection on both sides.
• Antibiotic treatment with teicoplanin was administered.
• Cerebral vascularization was preserved at 12-month follow-up.

Implications:

• Prompt diagnosis and surgical intervention are crucial for managing infected false aneurysms.
• Mandatory wound cultures are essential for identifying causative pathogens.
• Arterial reconstruction techniques, such as end-to-end anastomosis or saphenous vein grafting, are effective.
• This case highlights the importance of vigilance for rare complications in vascular surgery.