Elsevier

Annals of Vascular Surgery

Volume 8, Issue 5, September 1994, Pages 409-416
Annals of Vascular Surgery

Original Articles
Surgical Treatment of Extracranial Internal Carotid Artery Aneurysm

https://doi.org/10.1007/BF02133059Get rights and content

Aneurysms of the extracranial internal carotid artery are rare but can be responsible for severe complications such as rupture, thrombosis, or embolism. Between 1961 and 1985 we operated on 38 aneurysms of the extracranial internal carotid artery in 35 patients, 22 males and 13 females, whose ages ranged from 6 to 73 years. The underlying causes of aneurysm included atherosclerosis (12 cases), fibromuscular dysplasia (eight cases), a congenital defect (five cases), infection (one case), and trauma (six cases); in six cases aneurysm was secondary to spontaneous dissection. Signs of cerebral ischemia were present in 26 (74%) patients and a cervical mass was found in six. The aneurysm was proximal (i.e., below the angle of the mandible) in 16 patients and distal (i.e., above the angle of the mandible) in 22. After resection of the aneurysm, arterial continuity was restored in 37 patients by resection and grafting (12 cases), resection and anastomosis (11 cases), or arteriorrhaphy (14 cases). One death occurred 13 days after operation due to myocardial infarction. Two patients experienced a reversible neurologic event. Transient paresis of cranial nerves was observed in eight patients. During a follow-up period that ranged from 6 to 30 years, four patients were; lost to follow-up and 25 patients remained asymptomatic. Three patients had asymptomatic thrombosis of the carotid artery detected at follow-up investigations. The potential risks of cerebral ischemia and rupture and the satisfactory long-term results achieved with surgery are strong arguments in favor of surgical treatment for aneurysms of the extracranial internal carotid artery.

References (41)

  • R Nesbit et al.

    Bilateral internal carotid artery aneurysms

    Arch Surg

    (1979)
  • A Thévenet et al.

    Les anévrysmes exocrâniens de l'axe carotidien

  • J Biller et al.

    Cervicocephalic arterial dissections: A ten-year experience

    Arch Neurol

    (1986)
  • MG Luken et al.

    Spontaneous dissecting aneurysms of the extracranial carotid artery

    Clin Neurosurg

    (1975)
  • WA Friedman et al.

    Cervical carotid dissecting aneurysms

    Neurosurgery

    (1980)
  • F Ameli et al.

    Unusual aneurysms of the extracranial carotid artery

    J Cardiovasc Surg

    (1983)
  • R Labauge et al.

    Les anévrysmes du segment exocrânien de l'axe carotidien et leur traitement chirurgical: À propos de 13 observations personnelles

    Rev Neurol

    (1971)
  • W Kramer

    Hyperplasie fibromusculaire et anévrysme extracrânien de la carotide interne avec syndrome parapharyngien typique

    Rev Neurol

    (1969)
  • JP Mizon et al.

    Anévrysme extra-crânien de la carotide interne: À propos d'un cas situé sous la base du crâne

    Lille Méd

    (1975)
  • EA Rittenhouse et al.

    Carotid artery aneurysms: Review of the literature and report of a case with rupture in the oropharynx

    Arch Surg

    (1972)
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    Presented at the Annual Meeting of the Société de Chirurgie Vasculaire de Langue Française, Reims, France, June 19–20, 1992.

    Reprint requests: A. Thévenet, MD, 14 Rue des Hospices, 34090 Montpellier, France.

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