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Endovascular coiling of a mycotic external carotid artery pseudoaneurysm following pharyngolaryngectomy with a free jejunal graft

  • J L C Smelt (a1), O Alhamarneh (a1), J D Dyer (a2) and L Liew (a1)



(1) To highlight the significance of carotid artery pseudoaneurysm as a rare complication following neck dissection, and (2) to suggest endovascular coiling as management, in the presence of infection, previous radiotherapy and a grafted blood supply.

Case report:

A 66-year-old man diagnosed with squamous cell carcinoma of the hypopharynx and upper oesophagus underwent pharyngolaryngectomy with reconstruction of a neo-pharynx using a free jejunal graft. The patient had previously received radiotherapy for a soft palate squamous cell carcinoma. Two months after surgery, computed tomography demonstrated a bilobed pseudoaneurysm of the left external carotid artery just distal to the arterial branch supplying the jejunal graft. This mycotic pseudoaneurysm was successfully treated with endovascular coiling, while maintaining the patency of the superior thyroid artery supplying the jejunal graft anastomosis.


In this patient, endovascular coiling of the external carotid artery was considered to be the only definitive treatment for a life-threatening mycotic pseudoaneurysm.


Corresponding author

Address for correspondence: Mr J L C Smelt, 2 Horwood Road, Nailsea, Bristol, BS48 2LN, UK E-mail:


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1Garino, JP, Ryan, TJ. Carotid haemorrhage: a complication of peritonsillar abscess. Am J Emerg Med 1987;5:220–3
2Schwartz, ML, Fisher, R, Sako, Y, Castaneda, AR, Grage, TB, Nicoloff, DM. Post-traumatic aneurysms of the thoracic aorta. Surgery 1975;78:589–93
3Baril, DT, Ellozy, SH, Carroccio, A, Patel, AB, Lookstein, RA, Marin, ML. Endovascular repair of an infected carotid artery pseudoaneurysm. J Vasc Surg 2004;40:1024–7
4Biggs, KL, Chiou, AC, Hagino, RT, Klucznik, RP. Endovascular repair of a spontaneous carotid artery dissection with carotid stent and coils. J Vasc Surg 2004;40:170–3
5Osler, W. The Gulstonian Lectures on malignant endocarditis. Br Med J 1885;1:467–70
6Goddard, AJ, Lenthall, RK, Bradley, PJ. Endovascular management of infected carotid artery pseudoaneurysm complicating pharyngolaryngectomy: complete occlusion followed by early recurrence and rebleeding. J Laryngol Otol 2004;118:991–5
7Worley, GA, Hern, JD, O'Sullivan, GJ, Tassone, P, Hinton, AE. Mycotic aneurysm of the external carotid artery. J Laryngol Otol 1998;112:793–5
8Girishkumar, HT, Sivakumar, M, Andaz, S, Santosh, V, Solomon, R, Brown, M. Pseudoaneurysm of the carotid bifurcation secondary to radiation. J Cardiovasc Surg 1999;40:877–8
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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
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