A Hybrid Approach to Iatrogenic Proximal Common Carotid Pseudoaneurysm: Innominate Balloon Occlusion and Open Repair

Managing carotid artery pseudoaneurysms in the setting of sepsis and hostile neck anatomy presents significant therapeutic challenges. This report describes a case in which a hybrid strategy—combining endovascular balloon occlusion for proximal control with open surgical repair—was successfully employed in a critically ill patient with multiple comorbidities. The approach was tailored to address anatomical complexity and infection risk, avoiding the limitations of isolated endovascular or open techniques. Thus underscores the role of hybrid interventions as a practical and adaptable solution for complex Zone I vascular injuries in resource-constrained or infection-prone settings.