Carotid artery aneurysm: Evolution of management over two decades

Abstract

Treatment modality of CCA has largely evolved from operative to endovascular intervention at our institution. Treatment benefits of endovascular modality include shorter convalescent and less procedural-related complications. This evolution reflects the improvement of endovascular devices and increased utility of endovascular applications.

Overlapped Stenting for Treatment of an Extracranial Carotid Artery Aneurysm

“…3) Endovascular treatment is less invasive than open surgery, and endovascular treatment for ECAA is increasingly being reported in recent years. 6) However, covered stents are used relatively often in such cases. 4) Although a covered stent would certainly be reasonable, rapidly effective, and seem to be an ideal device, the long-term patency of covered stents is unknown.…”

“…Zhou et al 6) reported that, among 42 patients who were followed up for a mean of 4.6 years after ECAA treatment, 11 patients died due to cardiac disease. This is convincing, considering that atherosclerosis is the most common cause of ECAA.…”

Technical Options for the Surgical Management of Extracranial Carotid Artery Aneurysms

“…4,12,21) A revolution from surgical repair to endovascular intervention for ECA aneurysm was documented at a large center. 25) The endovascular technique can be advocated as an emerging alternative treatment with high procedure success and relatively low complication rate in patients with ECA aneurysm.…”

Iatrogenic Pseudoaneurysms

“…If this occurs, intra-arterial thrombolysis may be undertaken. [13] At the Oxford University Hospitals, UGTI has been used as first-line therapy for the treatment of iatrogenic femoral pseudoaneurysms. Between August 2005 and July 2011, 94 patients underwent UGTI for treatment of iatrogenic pseudoaneurysms.…”

“…Carotid aneurysms make up less than 1% of all carotid pathologies, and of these, roughly 1 in 3 are pseudoaneurysms. [13] In modern practice, the more common causes include inadvertent catherisation during attempted internal jugular vein central line placement, trauma (blunt or penetrating), and pseudoaneurysm formation in the anastomotic suture line following carotid endarterectomy. Local infection (e.g.…”