Aneurisma da artéria carótida interna

Abstract

Extracranial internal carotid artery aneuriysms (EICAA) are rare. There are few reports in the medical literature about its etiology, relating these aneurysms to atherosclerosis, arteritis and alterations due to trauma or after surgical procedure. The natural history of the disease has not been well-defined yet. However, the potential risk of embolism originating from the aneurysm -or even its rupture -indicates a need for intervention. We present the case of a seventy-one year old woman, who was diagnosed an aneurysm of three cm diameter of the right EICA, with throbbing headache complaints. After an unsuccessful attempt of endovascular treatment, we performed a surgical procedure with aneurysmectomy and primary end-to-end anastomosis near the skull base.Keywords: aneurysm; internal carotid artery; surgery. ResumoOs aneurismas de artéria carótida interna (ACI) extracraniana são raros. Há poucos relatos na literatura médica quanto à sua etiologia, relacionando-os à doença aterosclerótica, às arterites e alterações decorrentes do trauma ou após procedimento cirúrgico. A história natural da doença ainda não está bem estabelecida. Entretanto, o potencial risco de embolia originário do aneurisma ou mesmo de sua ruptura indica necessidade de intervenção. Apresentamos o relato de caso de uma mulher de 71 anos diagnosticada com aneurisma de 3 cm de diâmetro da ACI extracraniana direita com queixas de cefaleia pulsátil. Após tentativa sem sucesso de tratamento endovascular, optou-se pelo tratamento cirúrgico com aneurismectomia e anastomose primária término-terminal próximo à base do crânio.Palavras-chave: aneurisma; artéria carótida interna; cirurgia.

Acesso cirúrgico ao segmento cervical distal da artéria carótida interna e à bifurcação carotídea alta – revisão integrativa da literatura e proposta de protocolo

“…Next, the majority of authors recommend dissection along the anterior (medial) margin of the SCM muscle for lateral retraction. 3 , 5 - 17 , 21 , 23 , 25 - 28 , 32 - 38 , 40 , 44 - 50 , 52 - 57 The facial vein should be ligated and the hypoglossal loop can be sectioned, exposing the entire cervical portion of the CCA and a mean of 26.95 mm (varying from 15 to 45 mm) 5 of the proximal segment of the ICA, equivalent to the level of the upper third of C2. 8 , 30 However, dissections via posterior routes are also described, such as the retrojugular access 30 and via the retromandibular fossa.…”

“…Em seguida, a maior parte dos autores orienta a dissecção ao longo da borda anterior (medial) do ECM para retração lateral 3 , 5 - 17 , 21 , 23 , 25 - 28 , 32 - 38 , 40 , 44 - 50 , 52 - 57 . A veia facial deve ser ligada, e a alça do hipoglosso pode ser seccionada, expondo toda a porção cervical da ACC e uma média de 26,95 mm (variação de 15 a 45 mm) 5 do segmento proximal da ACI, equivalente ao nível do terço superior de C2 8 , 30 .…”

Surgical access to the distal cervical segment of the internal carotid artery and to a high carotid bifurcation – integrative literature review and protocol proposal

“…5 Next, the majority of authors recommend dissection along the anterior (medial) margin of the SCM muscle for lateral retraction. 3,[5][6][7][8][9][10][11][12][13][14][15][16][17]21,23,[25][26][27][28][32][33][34][35][36][37][38]40,[44][45][46][47][48][49][50][52][53][54][55][56][57] The facial vein should be ligated and the hypoglossal loop can be sectioned, exposing the entire cervical portion of the CCA and a mean of 26.95 mm (varying from 15 to 45 mm) 5 of the proximal segment of the ICA, equivalent to the level of the upper third of C2. 8,30 However, dissections via posterior routes are also described, such as the retrojugular access 30 and via the retromandibular fossa.…”

Surgical repair of an extracranial carotid aneurysm

“…1 Occurrence of isolated aneurysms of the extracranial carotid artery is even rarer. 2 The anatomic relationships between vessels, combined with progressive increase in aneurysm diameter, can lead to neurological conditions such as Horner syndrome and dislocation of the trachea with resulting dyspnea. 3 Additionally, the habitual formation of thrombus within the aneurysm sac can cause embolization and stroke.…”

“…1 A range of surgical treatment techniques have been employed, [4][5][6][7] in addition to endovascular options. 2,8…”