TY  - EJOU
AU  - Zhang, Yaqi 
AU  - Hu, Liang 
AU  - Zhang, Yuxi 
AU  - Qian, Bo 
AU  - Qi, Jirong 
AU  - Peng, Wei 

TI  - Carotid Artery Pseudoaneurysm in a Pediatric Patient Following ECMO: Management with Carotid Artery Ligation and Pseudoaneurysm Resection under Balloon Occlusion-Guided DSA
T2  - Structural and Congenital Heart Disease

PY  - 2025
VL  - 20
IS  - 1
SN  - 3071-1738

AB  - <b>Background:</b> Carotid artery pseudoaneurysm in children is rare; typically caused by trauma; surgical interventions and infection. These aneurysms can lead to significant 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. <b>Case Description:</b> 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 confirmed 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 deficits or complications; and regular follow-up confirmed no further adverse sequelae. <b>Conclusions:</b> 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.
KW  - Carotid pseudoaneurysm; VA-ECMO; DSA; heart transplantation

DO  - 10.32604/chd.2025.063072