case_images: PMC11263163_01
case_images: Huge dorsal abscess opened and drained with the microbiological examination positive for Staphylococcus aureus.
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case_images: F1
case_images: However, there was a huge dorsal abscess, which was immediately opened and drained (Figure 1).
case_images: (A,B) CT scan in LL and AP projection showing a 48-mm x 38-mm pseudoaneurysm of the left carotid bifurcation without any cerebral embolic signs. LL, laterolateral; AP, anteroposterior.
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case_images: F2
case_images: Based on clinical findings and imaging studies, our diagnosis was a mycotic pseudoaneurysm (Figures 2A, B).
case_images: (A,B) CT control in AP and LL projection after endovascular exclusion of the mycotic pseudoaneurysm using a stent graft. LL, laterolateral; AP, anteroposterior.
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case_images: F3
case_images: Advantia (Atrium medical corporation, Gentinge Australia Pty Ltd) balloon-expandable covered stent that was deployed across the healthy segment of the common carotid artery (CCA) proximally and the internal carotid artery (ICA) distally (Figures 3A,B), without embolization of the external carotid artery. A loading dose of aspirin and clopidogrel was administrated before the deployment of the stent graft.
case_images: (A) Intraoperative image showing the pseudoaneurysm sac opened. (B) Intraoperative image showing stent graft removal. (C) Intraoperative image showing the Sundt shunt for cerebral perfusion. (D) Open surgical carotid artery reconstruction using the great saphenous vein graft.
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case_images: F4
case_images: The pseudoaneurysm sac was opened, the previously placed stent graft was extracted, and the surrounding inflammatory tissue was debrided (Figure 4A). After obtaining proximal and distal control, a large portion of the infected carotid artery, including the stent, was surgically removed, and cerebral perfusion was maintained using a Sundt shunt (Figures 4B,C). The resected segment was replaced with a similarly sized section of the great saphenous vein (Figure 4D).
case_images: (A,B) 1-year CT scan showing good patency of the graft without imaging of cerebral ischemia.
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case_images: F5
case_images: Follow-up computed tomography (CT) scans at 1 month, 6 months, and 1 year demonstrated patency of the graft (Figures 5A,B) with no signs of cerebral ischemia.