Explusion of SALIBI-clamp from the internal carotied artery in the neck by infection.

A left infraclinoid carotid aneurysm (3 x 2-5 x 2 cm) in a 60-year old woman presented with total ophthalmoplegia and trigeminal symptoms. A staged internal carotied occlusion in the neck was performed using a SALIBI-clamp. A chronic infectious fistula developed (Klebsiella aerogenes). When superficial debridement failed, operative removal of the SALIBI-clamp was planned seven months after its insertion. The clamp was found subcutaneously without any relation to the internal carotid artery and was easily removed. Subsequent catheter angiography proved the left internal carotied to be completely occluded in the neck. No cross filling of the aneurysm could be demonstrated from the right carotied nor the vertebro-basilar arteries. The neurological deficit remained unchanged. The wound closed promptly without further signs of infection.