title: Differentiated treatment of aneurysms of the extracranial carotid artery.
abstract: OBJECTIVE
  Aim of the study is to illustrate current therapeutic options for aneurysms of the extracranial carotid artery.
  
  
  METHODS
  From 1987 until 2003 14 patients (average age: 60 years) with an aneurysm of the extracranial internal carotid artery were treated. The aneurysm diameter ranged from 5 mm to 60 mm. Thirteen patients underwent elective surgery. One patient was operated upon because of acute severe cervical bleeding.
  
  
  RESULTS
  Most patients (10/14) presented with an asymptomatic pulsatile cervical mass. The aneurysm was diagnosed 3 times during carotid angiography. The underlying etiology was atherosclerosis in 10 patients. In 3 cases the aneurysm was considered mycotic. Ten aneurysms were localized at the carotid bifurcation whereas 2 each were found in the retrostyloideal region and at the base of the skull. Vascular continuity could be restored in 10 patients while in 3 the carotid artery had to be occluded (twice surgically and once radiologically). The final patient underwent stent insertion for post-traumatic distal aneurysm. In 5 patients perioperative neurological complications were noted which persisted in a single patient (dysphagia due to a lesion of the hypoglossus nerve). All hemispheric complications recovered completely. During follow-up (median 48 months ranging from 3 to 103 months), 1 patient died of unrelated cause. Another patient developed a contralateral ischemic insult.
  
  
  CONCLUSIONS
  When adjusting treatment to the various etiological conditions and localizations, aneurysms of the extracranial carotid artery can be managed with a low complication rate and satisfying long-term results. However, success mainly depends on the timely diagnosis and availability of a range of surgical and radiological therapeutical options.
authors.affiliation: Division of Vascular Surgery, Department of Visceral and Vascular Surgery, University of Cologne, Germany. Marko.Aleksic@medizin.uni-koeln.de
authors.forename: M
authors.initials: M
authors.lastname: Aleksic
authors.forename: J
authors.initials: J
authors.lastname: Heckenkamp
authors.forename: M
authors.initials: M
authors.lastname: Gawenda
authors.forename: J
authors.initials: J
authors.lastname: Brunkwall
mesh_terms: D000783:Aneurysm / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D002340:Carotid Artery Diseases / Q000601:surgery*; D002343:Carotid Artery, Internal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D013997:Time Factors