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February 1975

Mycotic Aneurysm of the Carotid Artery

Author Affiliations

San Francisco

Arch Surg. 1975;110(2):225. doi:10.1001/archsurg.1975.01360080091022

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To the Editor.–I read with interest and chagrin the article "Mycotic Aneurysm of the Carotid Artery" (Arch Surg 109:496, 1974) by Ledgerwood and Lucas, which was followed by an editorial comment by one of the Archives' editors. This article reported three cases of mycotic aneurysms in the carotid artery. Treatment included proximal ligation of the innominate, left carotid, and left internal carotid arteries. In the first two patients, a second operation was required to place the distal ligature on the involved vasculature. The thrust of this article seemed to emphasize proximal ligation, followed by an interval of seven to 14 days for antibiotic therapy, and then distal ligation. Vascular reconstruction "will almost always be prevented by the absence of an uninvolved tissue plane, due to the extent of soft tissue infection." They avoided any discussion of the possibility of carotid artery stump pressures as a means of determining which

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