Treatment of Extracranial Carotid Artery Aneurysm: Fifteen Years’ Experience at a Single Institution

Qiu, Jian; Zhou, Wei; Zhu, Xiaoxin; Zeng, Qinfu; Huang, Li; Tang, Xinhua; Yuan, Qing

doi:10.1016/j.avsg.2020.05.052

Cited by 9 publications

(8 citation statements)

References 16 publications

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“…Although with favorable outcomes in both short and long term, open surgery is associated with high occurrence of cranial nerve damage 11 . On the contrary, covered stent in endovascular therapy can immediately exclude blood flow from aneurysms, thereby minimizing complications associated with rupture or local compression 32,33,41–46 …”

Section: Discussionmentioning

confidence: 99%

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Surgical management of extracranial internal carotid artery aneurysm—Case report and literature review

Jaha,

Ademi,

Rudari

et al. 2023

Clinical Case Reports

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Key Clinical MessageExtracranial internal carotid artery aneurysms (EICAAs) can lead to serious medical conditions, such as stroke or compression over cranial nerves. In very few cases, there may be hemorrhagic complications due to the rupture. Although rare, they should be suspected cause in every patient with transitory ischemic attack or stroke, especially in the presence of pain, palpable mass or bruit in the neck.AbstractExtracranial internal carotid artery aneurysms (EICAAs) are rare arterial aneurysms, with a prevalence of less than 1%. Although they are not common, these aneurysms can lead to serious medical conditions, such as stroke or compression over cranial nerves. In very few cases, there may be hemorrhagic complications due to the rupture of the aneurysm. This report presents a case of a successful surgical intervention for EICAA, and an overview of symptoms, risk factors, causes, diagnostic procedures, treatments, and potential postoperative complications. A 70‐year‐old Albanian lady had been experiencing pain due to a pulsating mass in her neck for many years. Physical examination did not reveal any signs of infection, injury, or previous surgery. A palpable thrill and a carotid bruit were detected over an evident pulsating mass on the left side of her neck. Her past medical history was consistent with three transitory ischemic attacks in recent months and a stroke 5 years earlier. Comorbidities included hypercholesterolemia, hypertension, and long‐standing coronary artery disease. Imaging investigation in terms of ultrasound and CT‐scan confirmed the presence of an aneurysm of the proximal tract of the internal carotid artery measuring 42 × 31 mm. Surgery was indicated on symptomatic and anatomical grounds. The procedure was carried out under general anesthesia. After proximal and distal clamping, the aneurysm was excised followed by end‐to‐end anastomosis of the internal carotid artery. The postoperative course was uneventful, and the patient was discharged home on the fifth postoperative day. Despite the growing number of reported cases of successful endovascular treatment for internal carotid artery aneurysms, open surgery remains a safe and effective treatment option. However, it is crucial to provide customized treatment plans for each patient based on their individual characteristics and the particularities of their aneurysm.

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Section: Discussionmentioning

confidence: 99%

“… 11 On the contrary, covered stent in endovascular therapy can immediately exclude blood flow from aneurysms, thereby minimizing complications associated with rupture or local compression. 32 , 33 , 41 , 42 , 43 , 44 , 45 , 46 …”

Section: Discussionmentioning

confidence: 99%

Surgical management of extracranial internal carotid artery aneurysm—Case report and literature review

Jaha,

Ademi,

Rudari

et al. 2023

Clinical Case Reports

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“… 4) Treatment is necessary in some patients because of the possibility of rapid growth, rupture, and ischemic stroke. 5) Although open surgery is a common treatment and has been reported to be effective, 6 – 8) recent advances in endovascular devices and techniques have led to an increase in endovascular treatment using stents and covered stents for ECAA. 9 – 11) …”

Section: Introductionmentioning

confidence: 99%

Overlapped Double-Layer Micromesh Stents for Giant Extracranial Internal Carotid Artery Aneurysm

Murakami

Toyota

Takahara

et al. 2023

JNET

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Objective Extracranial internal carotid artery aneurysms (ECAAs) are rare. We herein describe a case of overlapped stenting with two double-layer micromesh stents for a giant ECAA. Case Presentation A 73-year-old man presented to our hospital with an enlarged right posterior cervical mass. A right internal carotid artery (ICA) angiogram revealed a giant aneurysm of 50 × 60 mm. We chose a carotid double-layer micromesh stent for stenting. With the patient under general anesthesia, the first double-layer micromesh stent (CASPER Rx, 10 × 30 mm; Terumo, Tokyo, Japan) was deployed between the ICA distal to the aneurysm and the common carotid artery (CCA). The second stent was also deployed from a site more proximal than the first one. Ten coils were then placed from a microcatheter that had been placed in the aneurysm. A right CCA angiogram after the procedure revealed a flow-diversion effect for the aneurysm. The patient was discharged with no complications. At the 6-month follow-up angiogram, blood flow into the aneurysm had completely disappeared. Conclusion A flow-diversion effect using overlapped double-layer micromesh stents can result in thrombosis and healing of giant ECAAs.

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“…4 In the past ten years, with the development of endovascular techniques, the treatment options of carotid artery aneurysms include open surgery, endovascular procedures and hybrid techniques. 1 A review published by Qiu et al reports that the optimal management option for the treatment of J o u r n a l P r e -p r o o f 3 carotid artery aneurysms is dependent upon the morphology of the artery and the properties of the aneurysm. Recent advances in endovascular treatment allows for the utilization of flow diversion outside the skull and treatment of extracranial internal carotid artery pseudoaneurysms with flow diversion has been shown to be safe and effective in selected patients.…”

mentioning

confidence: 99%

“…Extracranial carotid artery aneurysm has a prevalence of 0.4%-1% among all peripheral artery aneurysms. 1 The neurologic symptoms experienced by patients include transient ischemic attacks and ischemic strokes. 2 The first successful treatment for an aneurysm in this location was performed by Sir Astley Cooper in 1808 through ligation of the proximal carotid artery.…”

mentioning

confidence: 99%

Flow diversion device for the management of an extracranial internal carotid artery aneurysm

Fortich

Sandhu

Tawk³

et al. 2022

Journal of Vascular Surgery Cases, Innovations and Techniques

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Treatment of Extracranial Carotid Artery Aneurysm: Fifteen Years’ Experience at a Single Institution

Cited by 9 publications

References 16 publications

Surgical management of extracranial internal carotid artery aneurysm—Case report and literature review

Surgical management of extracranial internal carotid artery aneurysm—Case report and literature review

Overlapped Double-Layer Micromesh Stents for Giant Extracranial Internal Carotid Artery Aneurysm

Flow diversion device for the management of an extracranial internal carotid artery aneurysm

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