Management of extracranial carotid artery aneurysms: 17 years' experience.
OBJECTIVE
a retrospective review of seventeen-year (1980-1996) experience of the management of extracranial carotid artery aneurysms.


METHODS
sixty-six aneurysms of extracranial carotid artery were seen in 63 patients. The diagnosis was confirmed by angiography in 51 patients and duplex ultrasonography in twelve. Twenty-eight (42%) patients had an atherosclerotic aneurysm, twenty-two (33%) had false aneurysms secondary to trauma, nine were congenital and seven were mycotic. All underwent aneurysm resection with saphenous-vein-graft interposition as the most common means of reconstruction.


RESULTS
one death occurred due to septicaemia in a diabetic patient with a mycotic aneurysm, giving an operative mortality of 1.5%. One patient had an immediate hemiparesis after carotid artery ligation, and three had a hemiparesis within 48 hours of operation (6.1%). After a change in technique to avoid a residual carotid stump, no further neurological problems were encountered in the following 28 patients.


CONCLUSIONS
extracranial carotid aneurysms may be successfully managed with resection and reconstruction with autogenous saphenous vein. End-to-side anastomosis avoids a blind-ending stump which may be the source of emboli.
Zhang
Q
Q
Department of Surgery, The First Teaching Hospital, Shenyang, 110001, China.
Duan
Z Q
ZQ
Xin
S J
SJ
Wang
X W
XW
Dong
Y T
YT
D000328:Adult; D000368:Aged; D001807:Blood Vessel Prosthesis; D002340:Carotid Artery Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000601:surgery; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000637:transplantation; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex