Infected false aneurysms of the carotid arteries after carotid endarterectomy

Abstract

To determine the incidence and management of infected false aneurysms following carotid endarterectomy. Case notes of patients undergoing carotid endarterectomy (CEA) between the years of 1980 and 1993 at two major teaching hospitals, or those patients who represented with complications were reviewed. Eight patients were identified with infected false aneurysms, an incidence of 0.625%, in five CEA had been performed at one of the teaching hospitals, whilst in three other cases the primary operation had been done elsewhere. Presentation was a median 19 days following CEA. In five cases the original arteriotomy was closed by direct suture whilst in three a saphenous vein patch was used. Staphylococcal organisms were cultured in all cases. Antibiotics had not been administered at the original operation. Repair with saphenous vein graft from the common to the internal carotid artery had the least complications. Infected false aneurysms are a rare complication following CEA, resection of the false aneurysm and reconstruction with autologous saphenous vein is recommended. Ligation alone is associated with a high incidence of stroke.