Pseudo-aneurysm of the carotid bifurcation secondary to radiation

Pseudoaneurysms of the extracranial carotid vessels have a varied etiopatho genesis. Cases have been attributed to spontaneous rupture, following tonsi llectomy or peritonsillar abscesses, trauma, postanastamotic and, rarely, p ostirradiation, and ECMO. The authors present a case of a pseudoaneurysm in volving the carotid artery bifurcation following radiation therapy. A saphe nous vein graft was used to establish continuity between the common and the internal carotid arteries. A vascular shunt was used to maintain cerebral perfusion during surgery. This case highlights the technical difficulties e ncountered in correcting this condition. This case exemplifies the technica l difficulties that are encountered in a complicated case such as this, Num erous previous operations and radiotherapy compounded the hazards of the su rgical procedure. Although technically challenging, every attempt must be m ade to resect pseudoaneurysms caused by radiation induced vascular damage.