A CASE OF IATROGENIC PSEUDOANEURYSM OF THE CAROTID ARTERY

Abstract

A case of iatrogenic pseudoaneurysm of the carotid artery is reported. The patient was a 55-year-old woman. After the operations of left middle cerebral arterial clipping for subarachnoidal hemorrhage and left superior neck ganglionectomy for left middle cerebral arterial spasms, she took an angiographic examination by way of left carotid arterial puncture. Twenty-five days after that examination, an expanding pulsatile tumor appeared on the left neck suddenly. Angiography revealed a pseudoaneurysm of the carotid artery. Emergency operation was performed on a diagnosis of impending rupture. The operative methods included total aneurysmectomy with partial excision of the common carotid artery and primary direct anastomosis. Probable major causes of an extracranial carotid aneurysm are atherosclerotic, non-specific inflammatory and traumatic, and iatrogenic pseudoaneurysm as this case is relatively rare. Though there is a questionable opinion of operative indication for atherosclerotic lesions, this case was thought to be an absolute candidate for operative indication. Here we also referred to the course of outbreak of the disease in this case.