[Surgical treatment of a giant extracranial internal carotid artery aneurysm--a case report].
BACKGROUND
True aneurysms of the extracranial internal carotid artery are rare lesions. Surgical treatment is considered to be the best therapeutic option. However, the use of the intraluminal shunt remains controversial.


METHODS
We reported a case of a giant extracranial internal carotid artery aneurysm treated by reconstructive surgery. A 76-year-old woman was referred with a pulsatile mass inside her mouth, associated with dizziness and dysarthria. There was no history of cerebrovascular symptoms, neck pain, or cervical trauma. A magnetic resonance scan showed a 45 mm aneurysm of the internal carotid artery (ICA), and kinking of ICA. Angiography demonstrated a saccular ICA aneurysm, with a lengthening and tortuosity of the ICA. The aneurysm and the carotid artery branches were easily exposed through a standard anterior cervical incision. After resection of the aneurysm, a Javid shunt was inserted between the common and internal carotid arteries, and end-to-end repair of ICA was easily performed due to ICA redundancy. The aneurysm was of atherosclerotic origin. Four months after the operation, the patient showed a complete recovery from peripheral neurological deficit.


CONCLUSIONS
Our results show that surgical reconstruction is a satisfactory therapeutic choice in the management of extracranial carotid artery aneurysms in order to avoid rupture, thromboembolism and cerebrovascular insufficiency. To date, there has been little experience with endoluminal exclusion techniques and the long-term effectiveness is still uncertain.
Pasternak
Janko
J
Institut za hirurgiju, Klinika za vaskularnu i transplantacionu hirurgiju, Klinicki centar Novi Sad, Novi Sad. paster@eunet.yu
Popović
Vladan
V
Vukobratov
Vladimir
V
Horvat
Zoltan
Z
Pfau
Jovan
J
Obradović
Jovan
J
D000368:Aged; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography