Surgical management of extracranial carotid artery aneurysms

Choudhary, Anwar; Evans, Richard J.; Naik, Dilip K.; Tripathi, Ravikesh; Wickremesekera, Janaka K.

doi:10.1111/j.1445-2197.2009.04860.x

Cited by 15 publications

(11 citation statements)

References 27 publications

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“…Ligasyon stroke riskinde artışla ilişkili olduğu için geri basınç 70 mmHg'yi aştığında güvenli biçimde yapılabilir. Çünkü bu intakt kontrolateral kan akımını ve patent Willus poligonunu gösterir [11]. Daha nadir kullanılan bir teknik ise rezeksiyon yapılmadan anevrizmanın bypassı ve ekstrakranial-intrakranial (EK-IK) bypasstır [3].…”

Section: Discussionunclassified

Carotid artery pseudoaneurysm after carotid endarterectomy: case report

Kaplanoğlu¹,

Beton²

2019

Ortadogu Tıp Derg

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ÖZEkstrakranial karotid arter anevrizmaları oldukça nadirdir. Tüm periferal arter anevrizmalarının %0.4-4'ünü oluşturmaktadır. Anevrizmaların nörolojik komplikasyonlarından kaçınmak için kesin tedavi gerekmektedir. Altmış yedi yaşında erkek hasta, üç ay önce efor sırasında ortaya çıkan göğüs ağrısı şikayeti ile hastanemiz kardiyoloji polikliniğine başvuruyor. Olguya yapılan efor testinin pozitif çıktı ve koroner anjiyografide koroner arterlerde darlık saptandı. Karotis Doppler ultrasonografide, sol internal karotid arterde %80 darlığa neden olan plak vardı. Dört damar bypass kararı alındı ve aynı senasta sol karotid endarterektomi yapıldı. Operasyonu takiben iki gün sonra hastanın boynunda şişlik ve morarma görüldü. Yapılan kontrol Doppler ultrasonografide sol internal karotid arterde anevrizma geliştiği izlendi. İlk operasyonu takiben bir hafta sonra tekrar opere edildi ve safen ven greft interpozisyonu ile uç uca anastamoz yapıldı. Altı aylık Doppler ultrasonografi kontrolleri ile takibi alındı. Anahtar kelimeler karotid arterler, karotis anevrizması, cerrahi, endovasküler teknikler Kaplanoğlu ve Beton / Karotid arter psödoanevrizması 208 ORTADOGU TIP DERG ABSTRACTExtracranial carotid artery aneurysms are quite rare. They account for 0.4% to 4% of all peripheral arterial aneurysms. Precise treatment is essential in order to avoid neurological complications of aneurysms. A 67-year-old male patient was admitted to the cardiology outpatient clinic of our hospital three months ago, with complaints of chest pain during exertion. The effort test of the case revealed a positive result, and coronary angiography revealed stenosis in the coronary arteries. The carotis doppler ultrasonography revealed plaque in the left internal carotid artery, causing 80% narrowing in the lumen. Four vessels were determine to be bypassed, and a left carotid endarterectomy was applied in the same session. Swelling and cyanosis were present in the patient's neck two days after the operation. The control doppler ultrasonography revealed the development of an aneurysm in the left internal carotid artery. The patient was operated on again one week after the first operation, and end-to-end anastomosis was applied with a saphenous vein interposition graft. The decision was made for follow-ups with doppler ultrasonography controls in six-month intervals.

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Section: Discussionunclassified

Carotid artery pseudoaneurysm after carotid endarterectomy: case report

Kaplanoğlu¹,

Beton²

2019

Ortadogu Tıp Derg

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“…Other etiologies have been reported, including traumatic, iatrogenic (post-carotid endarterectomy), infections, and systemic diseases, such as fibromuscular dysplasia or collagen diseases, including Marfan's syndrome. [138] The most common presenting symptom of ECAA is transient ischemic attack (TIA) caused by emboli. [12458] This is supported by the fact that thrombosis in the aneurysmal sac was found in up to 18% of ECAAs.…”

Section: Discussionmentioning

confidence: 99%

“…[138] The most common presenting symptom of ECAA is transient ischemic attack (TIA) caused by emboli. [12458] This is supported by the fact that thrombosis in the aneurysmal sac was found in up to 18% of ECAAs. [5] Accordingly, our case series showed intra-aneurysmal thrombus in 66% (two of three) of the cases.…”

Section: Discussionmentioning

confidence: 99%

“…Other presenting symptoms can include aneurysm rupture, paralysis of the cranial nerves due to compression by the giant aneurysm, and enlarging pulsatile or nonpulsatile neck mass. [138] Surgical treatment is generally accepted as a primary method of treating ECAA based on the high mortality risk in conservatively treated cases. [2] Total aneurysmectomy with direct end-to-end anastomosis or grafting, partial aneurysmectomy with patch closure, aneurysmorraphy, ligation of the ICA, or EC–IC bypass have been attempted as surgical management in previous reports.…”

Section: Discussionmentioning

confidence: 99%

“…[1310] Progressive enlargement of a cervical internal carotid artery (ICA)/common carotid artery (CCA) aneurysm can result in devastating sequela with possible rupture, lower cranial nerve injury, and intracranial embolic spray from intra-aneurysmal thrombi. However, a standard treatment strategy has not yet been established.…”

Section: Introductionmentioning

confidence: 99%

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Surgical strategy to minimize ischemia during trapping/resection of giant extracranial carotid artery aneurysm stratified by collateral evaluation

Hongo¹,

Inoue²,

Tamura³

et al. 2017

Surg Neurol Int

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Background:Extracranial carotid artery aneurysm (ECAA) is a rare clinical entity, and no standard treatment strategy has been established for this condition.Methods:Data from three patients who underwent surgical treatment of enlarging giant ECAAs were retrospectively reviewed. Based on the collateral status, as evaluated by preoperative digital subtraction angiography (DSA), surgical strategy was stratified into (1) high flow bypass followed by cervical ICA (internal carotid artery) ligation, when the collateral status was judged as poor/fair or (2) direct cervical repair with patch application after aneurysmal wall resection when the collateral status was judged as robust. Postoperative results were evaluated by magnetic resonance imaging (MRI).Results:Postoperative follow-up (day 0 to 1, as well as midterm at approximately 6 months) confirmed completely trapped aneurysm with successful robust bypass and robust anterograde flow of the reconstructed cervical carotid artery on magnetic resonance angiography with no additional ischemic lesions on diffusion weighted imaging and T2-weighted imaging when compared with preoperative imaging in all three patients. Postoperatively, there was no stroke event during the midterm follow-up at 6 months.Conclusions:Clinical results of ECAAs treated by a surgical strategy stratified based on collateral status, as evaluated by preoperative DSA, were favorable, without postoperative ischemic event, and with satisfactory mid-term MRI results.

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Cystic Swellings of the Anterior Triangle: Extracranial Carotid Artery Aneurysm

Sakr

2023

Lateral Neck Swellings

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Surgical management of extracranial carotid artery aneurysms

Cited by 15 publications

References 27 publications

Carotid artery pseudoaneurysm after carotid endarterectomy: case report

Carotid artery pseudoaneurysm after carotid endarterectomy: case report

Surgical strategy to minimize ischemia during trapping/resection of giant extracranial carotid artery aneurysm stratified by collateral evaluation

Cystic Swellings of the Anterior Triangle: Extracranial Carotid Artery Aneurysm

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