Open repair of an incidental internal carotid artery pseudoaneurysm discovered after cardiac arrest

Extracranial carotid artery aneurysms account for <1% of all arterial aneurysms and thus are scarcely reported in the literature. Recommendations for management can be difficult as there are no single agreed-upon guidelines for diagnosis and treatment. We present the case of a 56-year-old man with a symptomatic and CT imaging confirmed right pseudoaneurysm arising from a tortuous proximal internal carotid artery. Open resection of the pseudoaneurysm with primary repair by end-to-end anastomosis was performed. The patient recovered well without persistent neurological deficits, was discharged on dual antiplatelet therapy and a statin, and 3-month postoperative carotid artery duplex showed normal velocities.