Carotid Artery Reconstruction Using a Synthetic Graft Following Repair of an Infected Carotid Aneurysm in an Elderly Patient: A Case Report

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  • 人工血管を用いて再建を行った高齢者頚動脈感染性動脈瘤の1例

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An 89-year-old man presented to our hospital with a pulsatile mass in his neck. Based on magnetic resonance imaging (MRI) and blood tests, he was diagnosed as having an infected aneurysm of the right carotid artery bifurcation. Conservative therapy with antibiotic use was initiated. However, the aneurysm was found to rapidly increase in size. We decided to repair the culprit vessel walls because of the risk of lethal rupture. The aneurysm extended between the common carotid artery (CCA) and internal carotid artery (ICA). Strong adhesions were noted between the walls of the aneurysm and surrounding structures. The wall was difficult to dissect and showed leakage of blood, indicating vascular injury. Thus, resection of the CCA, ICA and external carotid artery (ECA) was performed, followed by reconstruction using a synthetic graft. The patient demonstrated no neurological deficit postoperatively, and postoperative magnetic resonance angiography (MRA) and MRI revealed a patent graft and no new ischemic lesion. Conservative therapy maintained his general condition without any vascular event. Extracranial aneurysms of the carotid artery without any associated history of traumatic events are rare. We discuss the treatment strategy for this condition based on previous reports.

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