Aneurysms of the extracranial carotid artery

Cn, McCollum; Wheeler, William G.; Noon, George P.; DeBakey, Michael E.

doi:10.1016/0002-9610(79)90144-2

Cited by 253 publications

(144 citation statements)

References 15 publications

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“…According to literature the incidence of transient focal neurological complications ranges from 3 to 17 %, whereas the rates in our series were 3.1 % and 9.6 % in short-and long-term observations, respectively [7,11,28,29]. Although the surgical treatment of ECCA is more diffi cult compared to carotid endarterectomy, it is followed by a similar postoperative complication rate [6,11,22].…”

Section: Discussionmentioning

confidence: 51%

“…Three patients in our series presented with this symptom (9.4 %). A pulsatile cervical mass and localised pain were the most frequent symptoms at the moment of diagnosis [20][21][22]. In our group, most of the patients presented with pulsatile cervical mass (23/ 32; 71.9 %) and associated regional pain at the time of diagnosis (16/32; 50 %).…”

Section: Discussionmentioning

confidence: 54%

“…After surgically treating ECCA, Knight et al described an early mortality rate of 6.3 % and McCollum et al of 7 % [6,22]. Dimtza described the fi rst case of revascularisation in 1956 with aneurysmal resection and end-to-end anastomosis and a favourable outcome with a death rate amounting to 14 % [30].…”

Section: Discussionmentioning

confidence: 99%

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Surgical management of extracranial carotid artery aneurysms

Skóra

Kurcz

Korta

et al. 2016

Vasa

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Abstract. Background: We present the methods and results of the surgical management of extracranial carotid artery aneurysms (ECCA). Postoperative complications including early and late neurological events were analysed. Correlation between reconstruction techniques and morphology of ECCA was assessed in this retrospective study. Patients and methods: In total, 32 reconstructions of ECCA were performed in 31 symptomatic patients with a mean age of 59.2 (range 33 - 84) years. The causes of ECCA were divided among atherosclerosis (n = 25; 78.1 %), previous carotid endarterectomy with Dacron patch (n = 4; 12.5 %), iatrogenic injury (n = 2; 6.3 %) and infection (n = 1; 3.1 %). In 23 cases, intervention consisted of carotid bypass. Aneurysmectomy with end-to-end suture was performed in 4 cases. Aneurysmal resection with patching was done in 2 cases and aneurysmorrhaphy without patching in another 2 cases. In 1 case, ligature of the internal carotid artery (ICA) was required. Results: Technical success defined as the preservation of ICA patency was achieved in 31 cases (96.9 %). There was one perioperative death due to major stroke (3.1 %). Two cases of minor stroke occurred in the 30-day observation period (6.3 %). Three patients had a transient hypoglossal nerve palsy that subsided spontaneously (9.4 %). At a mean long-term follow-up of 68 months, there were no major or minor ipsilateral strokes or surgery-related deaths reported. In all 30 surviving patients (96.9 %), long-term clinical outcomes were free from ipsilateral neurological symptoms. Conclusions: Open surgery is a relatively safe method in the therapy of ECCA. Surgical repair of ECCAs can be associated with an acceptable major stroke rate and moderate minor stroke rate. Complication-free long-term outcomes can be achieved in as many as 96.9 % of patients. Aneurysmectomy with end-to-end anastomosis or bypass surgery can be implemented during open repair of ECCA.

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Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 54%

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Surgical management of extracranial carotid artery aneurysms

Skóra

Kurcz

Korta

et al. 2016

Vasa

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“…9) Comprehensive information on ECA aneurysms is difficult to obtain because of their rarity, estimated between 0.1% and 3.7% of all carotid procedures, and between 0.4% and 4% of all peripheral artery aneurysms. 13,19,22) Only one ECA aneurysm is treated per year even in major institutions. 7) Nevertheless, these aneurysms are of interest because of their diverse etiologies and the need for correct choices of diagnostic and therapeutic strategies.…”

Section: Introductionmentioning

confidence: 99%

Technical Options for the Surgical Management of Extracranial Carotid Artery Aneurysms

Yoneyama

Kawashima

Sugiura³

et al. 2012

Neurol. Med. Chir.(Tokyo)

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Three cases of extracranial carotid artery (ECA) aneurysm were treated with various surgical options. Two female patients (74 and 37-year-old women) presented with pulsatile masses in their necks, which were confirmed as ECA aneurysms. Another 65-year-old woman presented with a calcified mass in her neck caused by an ECA aneurysm. The first case was treated with aneurysmorrhaphy with primary closure, the second with replacement of the involved site with vascular prosthesis, and the third with a high flow bypass with proximal ligation of the internal carotid artery. All three different surgical techniques were successful. ECA aneurysms are rare and require careful selection of the surgical method according to etiology, shape, and location of the ECA aneurysm. Proficiency in various vascular reconstruction techniques is a desirable prerequisite for the surgeon in-charge.

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“…7) The mechanisms underlying pseudoaneurysm formation after CEA include suture failure, degeneration of the arterial wall or patch material, and infection. 7) However, pseudoaneurysm caused by infection is very rare because the incidence of post-CEA infection is quite low at 0.025% to 0.625%, 6,7,13,15,17) and is most often caused by staphylococcal organisms. 15) The treatment presents some difficulties and problems compared with extracranial carotid artery aneurysm due to other causes.…”

Section: Introductionmentioning

confidence: 99%

Combined Surgical and Endovascular Treatment of Infected Pseudoaneurysm After Carotid Endarterectomy-Case Report-

Yasuda

Kuroda

Ushikoshi

et al. 2005

Neurol. Med. Chir.(Tokyo)

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A 67-year-old male presented with a rare pseudoaneurysm caused by infection after carotid endarterectomy (CEA) performed for stenosis of the left internal carotid artery (ICA). Wound infection and recurrent bleeding from the operated ICA developed 1 month after surgery. Serial angiography showed that the post-CEA pseudoaneurysm gradually increased in size. The carotid balloon occlusion test revealed that the patient could not tolerate permanent ICA occlusion because of poorly developed collaterals. Direct surgical exposure of the aneurysm was impossible due to tight adhesion of the surrounding tissue, so common carotid to middle cerebral artery bypass using a radial artery graft was performed followed by ligation of the distal common carotid artery. Subsequently, retrograde blood flow from the ICA to the aneurysm was interrupted by embolization of the external carotid artery coil through the facial artery. Combined surgical and endovascular treatment is a therapeutic option for patients with post-CEA pseudoaneurysm, if either direct or endovascular surgery is unfeasible.

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Aneurysms of the extracranial carotid artery

Cited by 253 publications

References 15 publications

Surgical management of extracranial carotid artery aneurysms

Surgical management of extracranial carotid artery aneurysms

Technical Options for the Surgical Management of Extracranial Carotid Artery Aneurysms

Combined Surgical and Endovascular Treatment of Infected Pseudoaneurysm After Carotid Endarterectomy-Case Report-

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