Carotid artery pseudoaneurysm

A carotid artery pseudoaneurysm can refer to a pseudoaneurysm involving any segment of the carotid artery.


As with pseudoaneurysms elsewhere, these lack all three layers of the arterial wall (intima, media and adventitia).

Pseudoaneurysm development can occur within hours to several years after initial arterial injury although normally presenting within 5 years 7.

Carotid arterial pseudoaneurysms can involve the following types depending on the portion of vessel involved


Pseudoaneurysms can arise from varying causes which include

  • trauma
    • penetrating trauma
    • blunt trauma
  • arterial dissection
  • vasculitides
  • infection - e.g. mycotic carotid arterial pseudoaneurysm 14
  • as an iatrogenic complication following procedures
    • following carotid endarterectomy- uncommon complication 5,7
    • following transsphenoidal surgery- ICA pseudoaneurysm formation - rare 9
    • surgical neck dissections-  rare 11-12
    • misplaced central venous lines-  rare 10

Radiographic features

Imaging evaluation is often with Doppler ultrasound and CT angiography.

Treatment and prognosis

Management options can range from traditional surgical repair to endovascular repair (stent placement -  combined stent placement and coil embolisation 7). Mortality rates of up to 30% have been reported in the case of external carotid arterial pseudoaneurysms. In certain situations, more conservative approaches are taken (i.e observation 13)

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