Endovascular treatment of HIV-associated spontaneous common carotid artery pseudoaneurysm in a case of miliary and CNS tuberculosis

Br J Neurosurg. 2018 Oct;32(5):567-569. doi: 10.1080/02688697.2016.1265090. Epub 2017 Jan 17.

Abstract

HIV and tuberculosis infections are known to be associated with vasculopathy including occlusive disease and aneurysm formation. We report a case of 43-year-old male with miliary and central nervous system (CNS) tuberculosis; recently, diagnosed as HIV seropositive, on antiretroviral and antitubercular treatment presenting with painful neck swelling. He was found to have common carotid artery (CCA) pseudoaneurysm that was managed by endovascular stent grafting. HIV vasculopathy-related CCA pseudoaneurysm is a potentially life-threatening rare entity. Treatment of an immunocompromised patient by endovascular approach minimizes hospital stay and avoids wound-related complications. To the best of our knowledge, there has been no case report describing endovascular treatment of CCA pseudoaneurysm in an HIV-positive patient with low CD4 count and coexistent disseminated tuberculosis.

Keywords: HIV; common carotid artery; endovascular; miliary; pseudoaneurysm; tuberculosis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antiretroviral Therapy, Highly Active
  • Antitubercular Agents / therapeutic use
  • CD4 Lymphocyte Count
  • Carotid Artery Injuries / etiology*
  • Carotid Artery Injuries / surgery*
  • Carotid Artery, Common
  • Endovascular Procedures / methods*
  • HIV Infections / complications*
  • Humans
  • Immunocompromised Host
  • Male
  • Stents
  • Tuberculosis, Central Nervous System / complications*
  • Tuberculosis, Central Nervous System / drug therapy
  • Tuberculosis, Miliary / complications*
  • Tuberculosis, Miliary / drug therapy

Substances

  • Antitubercular Agents