Clinical Research Studies
Extracranial carotid artery aneurysms: Texas Heart Institute experience*,**

https://doi.org/10.1067/mva.2000.104101Get rights and content
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Abstract

Background and Purpose: Aneurysms of the extracranial carotid artery (ECA) are rare. Large single-institution series are seldom reported and usually are not aneurysm type–specific. Thus, information about immediate and long-term results of surgical therapy is sparse. This review was conducted to elucidate etiology, presentation, and treatment for ECA aneurysms. Methods: We retrospectively reviewed the case records of the Texas Heart Institute/St Luke's Episcopal Hospital, Houston, and found 67 cases of ECA aneurysms treated surgically (the largest series to date) between 1960 and 1995: 38 pseudoaneurysms after previous carotid surgery and 29 atherosclerotic or traumatic aneurysms. All aneurysms were surgically explored, and all were repaired except two: a traumatic distal internal carotid artery aneurysm and an infected pseudoaneurysm in which the carotid artery was ligated. Results: Four deaths (three fatal strokes and one myocardial infarction) and two nonfatal strokes were directly attributed to a repaired ECA aneurysm (overall mortality/major stroke incidence, 9%); there was one minor stroke (incidence, 1.5%). The incidence of cranial nerve injury was 6% (four cases). During long-term follow-up (1.5 months–30 years; mean, 5.9 years), 19 patients died, mainly of cardiac causes (11 myocardial infarctions). Conclusion: The potential risks of cerebral ischemia and rupture as well as the satisfactory long-term results achieved with surgery strongly argue in favor of surgical treatment of ECA aneurysms. (J Vasc Surg 2000;31:702-12.)

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*

Competition of interest: nil.

**

Reprint requests: Rafik El-Sabrout, MD, Department of Cardiovascular Surgery, Transplantation Services, MC 2-114, PO Box 20345, Houston, TX 77225.