Management of Extracranial Carotid Artery Aneurysms: A 6-Year Case Series

Abstract

Background We discuss the presentation and management of extracranial carotid artery aneurysms (ECAAs) and to develop a new type of classification. Material/Methods A retrospective review of 35 ECAAs patients who were admitted in our institution from January 2010 to June 2016 was conducted. The mean follow-up period was 25.58±22.13 months. Results During the study period, 35 aneurysms were diagnosed and treated (mean age, 50.8±15.6 years; 15 men). There were 28 true aneurysms, 5 false aneurysms, and 2 dissecting aneurysms. A total of 16 patients with true aneurysms underwent open surgical treatment (group 1), whereas 15 received endovascular management, including all false and dissecting aneurysms (group 2). The remaining 4 true aneurysms were treated with hybrid operation (group 3). The patency rates of groups 1, 2, and 3 were 100%, 93.3%, and 100%, respectively. According to the Peking Union Medical College Hospital (PUMCH) Classification, all 24 cases of type Ia aneurysms were treated by either open surgery and/or endovascular treatment, whereas all 3 type Ib cases were treated solely by open surgery. All 5 type IIa patients were treated by endovascular treatment, with the exception of 1 failure that was transferred to hybrid operation. All 3 type IIb patients were treated by hybrid operation. Conclusions Open surgery was more frequently feasible in true aneurysms, and endovascular surgery was the first choice for false and dissecting aneurysms. Hybrid operation was available for complicated cases. The PUMCH classification may be helpful for selection of management strategies for ECAAs.

Surgical Management of a Type II Extracranial Internal Carotid Aneurysm near to the Skull Base

“…The incidence of true aneurysms involving the extracranial ICA accounts for less than 1% of cases [ 2 , 4 ], and clinical findings may vary according to their location, size, and etiology. The most common symptoms are pulsatile mass, local pain, and dysphagia, but more important manifestations that heighten suspicion of this pathology are neurological symptoms.…”

Giant saccular aneurysm of the internal carotid artery with adhesion to the vagus nerve: A Case Report

“…The endovascular approach of the ICA aneurysms has become more popular and was shown to be an effective treatment. Both covered and bare-metal stents have been reported [ 11 ]. Arterial embolism, recurrent stenosis, or occlusion are possible post-interventional complications.…”

Extracranial carotid artery pseudoaneurysm due to Mycobacterium tuberculosis

“…4 Endovascular repair with a stent-graft has been reported as a temporizing maneuver for ruptures or in high-risk patients who are not candidates for open surgery. 5 Chen and colleagues, 6 in their case series of 35 patients with ECCA pseudoaneurysm, concluded that the preferred approach was surgery for true aneurysms and endovascular for false and dissecting aneurysms. In our patient, because the swelling was large and there were compressive symptoms, he was not suitable for coiling or a stent-graft, so open surgical exploration was undertaken.…”