J Korean Neurosurg Soc.  2018 Mar;61(2):282-286. 10.3340/jkns.2017.0404.003.

True Aneurysms of the Extracranial Carotid Artery : An Evaluation of Two “Giant Aneurysms” and the Current Literature

• Altun G
• Pulathan Z
• Hemsinli D

• KMID: 2408031
• DOI: http://doi.org/10.3340/jkns.2017.0404.003

Abstract

True extracranial carotid artery aneurysms (ECCAs) are uncommon. Atherosclerosis is the most common etiological factor. Neck pain, a pulsatile mass and murmur at auscultation are the most common symptoms. ECCAs may exhibit severe clinical manifestations due to complications. Cases of rupture can be fatal. There is a risk of distal embolization and stroke in thrombosed cases. We discuss two cases of enlarged ECCA treated surgically in the light of the most recent literature.

Keyword

Carotid arteries; Aneursym; Surgical procedures, Operative

MeSH Terms

Aneurysm*
Atherosclerosis
Auscultation
Carotid Arteries*
Neck Pain
Rupture
Stroke
Surgical Procedures, Operative

Figure

• 

  Fig. 1 Intraoperative image of case 1. A 3×3.5 cm aneurysm beginning after the bifurcation of the right internal carotid artery. The distance between the aneurysm sac and bifurcation was about 3 cm. D.ICA : distal part of internal carotid artery, P.ICA : proximal part of internal carotid artery, CCA : common carotid artery.

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  Fig. 2 Digital subtraction angiography image from case 2. The elongation with kingking in internal carotid artery was remarkable. The external carotid artery (ECA) was also pushed by the aneurysm sac. D.ICA : distal part of internal carotid artery, P.ICA : proximal part of internal carotid artery, CCA : common carotid artery, R : right, LAT : lateral.

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  Fig. 3 Three-dimensional computerized tomography angiography image from case 2. Elongation and kinking are notable in the distal and proximal parts of the internal carotid artery. D.ICA : distal part of internal carotid artery, P.ICA : proximal part of internal carotid artery, CCA : common carotid artery.

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  Fig. 4 Atherosclerotic changes in the wall of dilate vessel segment : sub-intimal fibrosis and cholesterol clefts (Periodic acid-Shiff stain, ×100 high power field).

Reference

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