Background:Carotid artery pseudoaneurysm in children is rare;typically caused by trauma;surgical interventions and infection.These aneurysms can lead to signiffcant neurological and vascular risks;and their management...Background:Carotid artery pseudoaneurysm in children is rare;typically caused by trauma;surgical interventions and infection.These aneurysms can lead to signiffcant neurological and vascular risks;and their management remains challenging.While endovascular therapy has become the standard for giant pseudoaneurysms in adults;its use in children is limited.No established guidelines or long-term safety data exist for pediatric endovascular treatment.We present a child who developed a carotid artery pseudoaneurysm after venoarterial extracorporeal membrane oxygenation(VA-ECMO)support and heart transplantation;highlighting the management strategies and outcomes.Case Description:A 4-year-old boy with dilated cardiomyopathy was admitted for congestive heart failure and subsequently required VA-ECMO support due to worsening hemodynamics.After heart transplantation;the patient developed a persistent hoarseness and a rapidly enlarging neck mass.Imaging conffrmed the presence of a giant carotid artery pseudoaneurysm.Balloon occlusion-guided digital subtraction angiography(DSA)revealed adequate collateral circulation;allowing successful carotid artery ligation and pseudoaneurysm resection.Postoperative recovery was uneventful;with no neurological deffcits or complications;and regular follow-up conffrmed no further adverse sequelae.Conclusions:Management of carotid artery pseudoaneurysms in pediatric patients remains challenging.Under the guidance of DSA and with the assistance of balloon occlusion;precise aneurysm resection and vascular reconstruction can be achieved.In the event that vascular conditions limit the success of the repair;the balloon’s ability to occlude the parent artery and supplying vessels can safely facilitate the ligation of the parent artery of the aneurysm.展开更多
基金Supported by the Scientiffc Research Project of Jiangsu Maternity and Child Health Care Association(FYX202201).
文摘Background:Carotid artery pseudoaneurysm in children is rare;typically caused by trauma;surgical interventions and infection.These aneurysms can lead to signiffcant neurological and vascular risks;and their management remains challenging.While endovascular therapy has become the standard for giant pseudoaneurysms in adults;its use in children is limited.No established guidelines or long-term safety data exist for pediatric endovascular treatment.We present a child who developed a carotid artery pseudoaneurysm after venoarterial extracorporeal membrane oxygenation(VA-ECMO)support and heart transplantation;highlighting the management strategies and outcomes.Case Description:A 4-year-old boy with dilated cardiomyopathy was admitted for congestive heart failure and subsequently required VA-ECMO support due to worsening hemodynamics.After heart transplantation;the patient developed a persistent hoarseness and a rapidly enlarging neck mass.Imaging conffrmed the presence of a giant carotid artery pseudoaneurysm.Balloon occlusion-guided digital subtraction angiography(DSA)revealed adequate collateral circulation;allowing successful carotid artery ligation and pseudoaneurysm resection.Postoperative recovery was uneventful;with no neurological deffcits or complications;and regular follow-up conffrmed no further adverse sequelae.Conclusions:Management of carotid artery pseudoaneurysms in pediatric patients remains challenging.Under the guidance of DSA and with the assistance of balloon occlusion;precise aneurysm resection and vascular reconstruction can be achieved.In the event that vascular conditions limit the success of the repair;the balloon’s ability to occlude the parent artery and supplying vessels can safely facilitate the ligation of the parent artery of the aneurysm.
