Surgical treatment of extracranial internal carotid artery aneurysms

Abstract

Surgical reconstruction is a satisfactory therapeutic choice for EICA, even when located at the base of the skull.

Technical Options for the Surgical Management of Extracranial Carotid Artery Aneurysms

“…7,26) Other reported causes of true aneurysms are arteritis, infection, fibromuscular dysplasia, tuberculosis, human immunodeficiency virus, collagen-vascular disease, irradiation, Behcet's disease, and cystic medial necrosis. 2,7,8,14,18,19) There are also multiple causes of false aneurysms. Suture degeneration or infection after carotid endarterectomy and blunt or penetrating trauma to the cervical carotid artery were reported to produce false aneurysms.…”

“…10) Surgical repair is effective for avoiding thromboembolism-induced stroke or aneurysm rupture, but the incidence of postoperative cranial nerve dysfunction can reach up to 44%. 19) Mortality and major stroke rate still remains high at 9% for surgical reconstruction in a high volume center. 7) Endovascular techniques with coil embolization of the aneurysm or implantation of bare metal stents or covered stents aiming at thrombosis of the aneurysmal sac have been most recently reported as less invasive therapies.…”

“…9) Comprehensive information on ECA aneurysms is difficult to obtain because of their rarity, estimated between 0.1% and 3.7% of all carotid procedures, and between 0.4% and 4% of all peripheral artery aneurysms. 13,19,22) Only one ECA aneurysm is treated per year even in major institutions. 7) Nevertheless, these aneurysms are of interest because of their diverse etiologies and the need for correct choices of diagnostic and therapeutic strategies.…”

Surgical treatment of distal extracranial internal carotid artery aneurysms associated with pathological artery kinking

“…Они составляют 1-2% от всех поражений экстракраниальных отделов сон-ных артерий [1][2][3][4] и 0,8-4% аневризм других пери-ферических сосудов [5,6]. В исследовании Texas Heart Institute среди 7394 больных с аневризмами аорты и периферических артерий, которые были оперированы в этом центре с 1960 по 1995 г., у 67 (0,9%) пациентов диагностирована аневризма ВСА [7].…”

“…В настоящее время в большинстве случаев выполня-ется резекция аневризмы ВСА с протезированием последней или формированием анастомоза конец в конец [1,2,4,11,[14][15][16]. Проведение реконструк-тивной операции позволяет снизить развитие ОНМК и летальность до 4-10% [3,9]. Наибольшие трудности возникают при операциях по поводу аневризм дистальных отделов ВСА.…”