INFECTED FALSE ANEURYSMS OF THE CAROTID ARTERIES AFTER CAROTID ENDARTERECTOMY

Objective: To determine the incidence and management of infected false aneurysms following carotid endarterectomy. Design: Case notes of pat ients undergoing carotid endarterectomy (CEA) between the years of 198 0 and 1993 at two major teaching hospitals, or those patients who repr esented with complications were reviewed. Results: Eight patients were identified with infected false aneurysms, all incidence of 0.625%, in five the CEA had been performed at one of the teaching hospitals, whi lst in three other cases the primary operation had been done elsewhere . Presentation was a median 19 days following CEA. In five cases the o riginal arteriotomy was closed by direct suture whilst in three a saph enous vein parch was used. Staphylococcal organisms were cultured in a ll cases. Antibiotics had not been administered at the original operat ion. Repair with saphenous vein graft from the common to the internal carotid artery had the least complications. Conclusion: Infected false aneurysms are a rare complication following CEA, resection of the fal se aneurysm and reconstruction with autologous saphenous vein is recom mended. Ligation alone is associated with a high incidence of stroke.