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CASE REPORT article
Front. Surg.
Sec. Vascular Surgery
Volume 11 - 2024 |
doi: 10.3389/fsurg.2024.1394441
Hybrid endovascular and surgical staged approach for mycotic carotid pseudoaneurysm: a case report and a literature review
Provisionally accepted
Marianna Sallustro
1*
Ilaria Ficarelli
1*
Teresa Prisco
1*
Armando Pontarelli
1*
Giuseppe Foschini
1*
Marisole Toni
2*
Valerio Rinaldi
2*
Priscilla Nardi
2*
PIERGASPARE PALUMBO
2
Giulio Illuminati
2*
Vito D'Andrea
2
Carlo Ruotolo
1*- 1 Hospital Antonio Cardarelli, Naples, Campania, Italy
- 2 Sapienza University of Rome, Rome, Lazio, Italy
Abstract Background: Mycotic carotid pseudoaneurysms represent a challenge for surgeons. They are uncommon but associated with high mortality and morbidity. Methods: We present a case of a 61-year-old man with a mycotic pseudoaneurysm of carotid bifurcation. The case was managed by a staged approach of open arterial reconstruction using saphenous vein graft, after initial endovascular control using stent graft. We also reviewed the literature available. Results: The patient was discharged to home with patent carotid artery, no sign of infection or bleeding. A CT scan performed 1, 6 months and one year later confirmed the good patency of the graft without imaging of cerebral ischemia. Conclusions: Mycotic pseudoaneurysms of the extracranial carotid artery are rare and should always be surgically treated. This disease, even if rare, request early detection and treatment to avoid fatal outcome. Hybrid staged approach is suggested compared to one-staged surgery in order to avoid rupture ad improve clinical outcome using stent graft associated with antibiotic therapy as bridge treatment until definitive surgery to obtain arterial reconstruction with an autologous graft
Keywords: Arterial reconstruction, Mycotic pseudoaneurysm, Venous graft, Combined approach, Stent graft, Extracranial carotid artery
Received: 01 Mar 2024; Accepted: 17 Jun 2024.
Copyright: © 2024 Sallustro, Ficarelli, Prisco, Pontarelli, Foschini, Toni, Rinaldi, Nardi, PALUMBO, Illuminati, D'Andrea and Ruotolo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Marianna Sallustro, Hospital Antonio Cardarelli, Naples, 80131, Campania, Italy
Ilaria Ficarelli, Hospital Antonio Cardarelli, Naples, 80131, Campania, Italy
Teresa Prisco, Hospital Antonio Cardarelli, Naples, 80131, Campania, Italy
Armando Pontarelli, Hospital Antonio Cardarelli, Naples, 80131, Campania, Italy
Giuseppe Foschini, Hospital Antonio Cardarelli, Naples, 80131, Campania, Italy
Marisole Toni, Sapienza University of Rome, Rome, 00185, Lazio, Italy
Valerio Rinaldi, Sapienza University of Rome, Rome, 00185, Lazio, Italy
Priscilla Nardi, Sapienza University of Rome, Rome, 00185, Lazio, Italy
Giulio Illuminati, Sapienza University of Rome, Rome, 00185, Lazio, Italy
Carlo Ruotolo, Hospital Antonio Cardarelli, Naples, 80131, Campania, Italy
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