Abstract
A 62-year-old man presented to our hospital with a pulsatile swelling on the right side of his neck. A gadolinium enhanced magnetic resonance arteriogram (MRA) confirmed that the swelling was a pseudoaneurysm at the site of the right carotid endarterectomy, performed 8 years earlier (Fig. 1). The patient originally presented in 1995 with right hemisphere transient ischaemic attacks. An arch arteriogram confirmed an 85% stenosis of the proximal right internal carotid artery. A standard carotid endarterectomy and Dacron patch repair was performed under antibiotic cover (augmentin and gentamycin) without neurological or wound complications. Ten months after discharge he developed inflammation and swelling on the right side of the neck. A duplex scan of the 2 cm mass revealed a fluid collection around the patch, but no evidence of an aneurysm. Aspiration confirmed pus and although no organisms were cultured, oral flucloxacillin was started for a presumed infection with staphylococcus
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