case_images: PMC8567690_01
case_images: Right latero-cervical mass (3 cm of large axis), with inflammatory signs all around (red arrow) with cutaneous ulceration 5 cm in diameter located under the right clavicular (blue arrow) (former location of the implantable chamber).
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case_images: The patient had a right latero-cervical tumefaction ( Figure 1) painful to palpation, pulsatile and expansive (3 cm-long large axis), with inflammatory signs all around. He also presented a cutaneous ulceration with a diameter of 5 cm, located under the right clavicle (former location of the implantable chamber), with inflammatory signs all around ( Figure 1).
case_images: Cervical computed tomography angiogram showing a 3 cm right common carotid artery pseudoaneurysm beginning at 2 cm of its origin and at a distance from the carotid bifurcation (red arrow), with the presence of multiple cervical lymphadenopathies.
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case_images: A cervical Angio-Computed Tomography (CT) scan ( Figure 2) showed a 3 cm pseudoaneurysm of the right CCA beginning 2 cm from its origin and at a distance from the carotid bifurcation, with the presence of multiple cervical lymphadenopathies and an unimpaired cerebral circulation through the polygon of Willis.
case_images: Preoperative view, the CCA was dissected and controlled and clamped at its origin and terminated just before the carotid bifurcation (blue arrow). Mycotic aneurysm, and all-around infected tissues were resected (yellow arrow).
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case_images: First, the CCA was dissected and controlled at its origin and terminated just before the carotid bifurcation ( Figure 3). An arterial clamping was made on both sides of the mycotic aneurysm, and resection of the latter, and all-around infected tissues, was performed ( Figure 3).
case_images: Preoperative view showing a cervical cutaneous fistula.
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case_images: However, given the extent of the infection with brittle arterial tissue, the existence of cutaneous fistula ( Figure 4), and the excellent pulsatile arterial reflux from the CCA, the decision was made to make a simple ligation of the artery to avoid complications, especially graft rupture ( Figure 5).
case_images: Preoperative view showing ligation of the two extremities of the CCA (yellow arrow) after total debridement of the infected area (green arrow).
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case_images: However, given the extent of the infection with brittle arterial tissue, the existence of cutaneous fistula ( Figure 4), and the excellent pulsatile arterial reflux from the CCA, the decision was made to make a simple ligation of the artery to avoid complications, especially graft rupture ( Figure 5).