False aneurysm complicating carotid endarterectomy.

Abstract:

:We present two cases of false aneurysm after carotid endarterectomy with primary arteriotomy closure. In both cases, infection appeared to be the precipitating cause. Both lesions were repaired with a saphenous vein patch graft, but infection in one patient persisted, and recurrence of a false aneurysm required ligation of the common carotid artery. There were no neurological sequelae in either patient. A review of the English language literature, our experience, and personal communications yielded 57 cases of false aneurysm. The overall incidence of false aneurysm after carotid endarterectomy was 0.30%. There was no significant difference in the incidence after endarterectomy alone and that after endarterectomy and patch grafting. A significant increase in neurological deficit occurred only when carotid ligation was used, with a morbidity/mortality of 50% in eight reported cases. Infection was the major cause of false aneurysm after endarterectomy; it occurred in 50% of cases closed primarily without patch grafting. Repair with a saphenous vein patch graft and monofilament synthetic suture, plus liberal use of antibiotics, should be considered in the treatment of this condition.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Branch CL Jr,Davis CH Jr

doi

10.1227/00006123-198609000-00014

subject

Has Abstract

pub_date

1986-09-01 00:00:00

pages

421-5

issue

3

eissn

0148-396X

issn

1524-4040

journal_volume

19

pub_type

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