Extracranial carotid aneurysm related to pregnancy

Abstract

Carotid aneurysms are rare, and pregnancy-related carotid aneurysms are rarer still. We report the case of an extracranial carotid aneurysm related to pregnancy. It was noted in the 20th week of gestation, and was uncomplicated. Surgery was successfully performed urgently to preempt embolism or rupture. The patient had a full-term normal delivery. The graft is patent, and the patient has no symptoms at 28-month follow-up. To the best of our knowledge, this case represents the first successful repair of an extracranial carotid aneurysm during pregnancy.

Extracranial Internal Carotid Artery Aneurysm in Pregnancy

“…4,6 True EICAAs in the absence of the aforementioned conditions are very uncommon, 8 and pregnancy-related carotid aneurysms are even rarer. 9…”

“…9 Our case described a pregnant young lady with an EICAA, with neither a history of congenital disorders nor features suggestive of infection. It has been postulated that pregnancy itself could increase the tendency of aneurysms to develop through multiple mechanisms, 9 including hemodynamic, hormonal, and other physiologic changes of pregnancy. 9 The hemodynamic changes during pregnancy may cause increased stress on the arterial wall, 10 and thereby favor arterial rupture and the development of aneurysms and pseudoaneurysms.…”

“…It has been postulated that pregnancy itself could increase the tendency of aneurysms to develop through multiple mechanisms, 9 including hemodynamic, hormonal, and other physiologic changes of pregnancy. 9 The hemodynamic changes during pregnancy may cause increased stress on the arterial wall, 10 and thereby favor arterial rupture and the development of aneurysms and pseudoaneurysms. 11 In the absence of a clear cause, histologic findings are required to precisely define the pathologic characteristics of an EICAA.…”

A Large Aneurysm in an Arterio-Venous Fistula for Renal Access in a Pregnant Young Woman

“…There are reports of pregnancy-related aneurysms of carotid, cerebral, hepatic, renal and splenic arteries (1-5). We have not found a case of an AVF aneurysm in pregnancy reported in the literature, and although aneurysm formation is a known complication of AVFs, it is particularly noteworthy that in this case the fistula was never needled for dialysis.…”

“…In the aortic wall, pregnancy causes loss of elastic fibers and a decrease in the amount of mucopolysaccharides, which is also hormone-mediated (10). Histologic studies of pregnancy-related aneurysms such as in the splenic and carotid arteries, have shown degenerative changes and an attenuation of the internal elastica, and cystic medial necrosis (1,2).…”