Spontaneous carotid blowout of the common carotid artery in a chronically immunosuppressed transplant patient

Ali Hakimi; Christina Stuart; Devin Zarkowsky; Michael R Clay; Jeniann Yi

doi:10.1016/j.jvscit.2022.10.005

Spontaneous carotid blowout of the common carotid artery in a chronically immunosuppressed transplant patient

J Vasc Surg Cases Innov Tech. 2022 Oct 18;8(4):715-718. doi: 10.1016/j.jvscit.2022.10.005. eCollection 2022 Dec.

Authors

Ali Hakimi¹, Christina Stuart², Devin Zarkowsky³, Michael R Clay⁴, Jeniann Yi⁵

Affiliations

¹ University of Colorado Anschutz School of Medicine, Aurora, CO.
² Department of Surgery, University of Colorado Anschutz School of Medicine, Aurora, CO.
³ Division of Vascular Surgery, Foothill Regional Medical Center, Newport Beach, CA.
⁴ Department of Pathology, University of Colorado Anschutz School of Medicine, Aurora, CO.
⁵ Division of Vascular Surgery and Endovascular Therapy, University of Colorado Anschutz School of Medicine, Aurora, CO.

Abstract

Carotid blowout (CB) is a life-threatening surgical emergency with a mortality rate of up to 60%. CB is commonly seen in head and neck cancer patients after surgical and radiation therapy; other causes include iatrogenic, traumatic, or infectious etiologies. We report an unusual case of spontaneous CB presumed to be caused by cytomegalovirus (CMV) in a chronically immunosuppressed transplant recipient. Given the significant mortality of CB and the prevalence of post-transplant CMV, this case highlights an area of further investigation regarding the association between CMV and carotid pathology, as well as the need to include CB as a potential infectious complication in the immunosuppressed population.

Keywords: Carotid blowout (CB); Carotid blowout syndrome (CBS); Chronic immunosuppression; Cytomegalovirus (CMV); Transplant.

Publication types

Case Reports