title: A 20-year experience with surgical management of true and false internal carotid artery aneurysms.
abstract: OBJECTIVE
  The aim of this study was to retrospectively analyse early and late results of surgical management of internal carotid artery (ICA) true and false aneurysms in a single-centre experience.
  
  
  METHODS
  From January 1988 to December 2011, 50 consecutive interventions for ICA aneurismal disease were performed; interventions were performed for true ICA aneurysm in 19 cases (group 1) and for ICA post-carotid endarterectomy (CEA) pseudo-aneurysm in the remaining 31 (group 2). Early results (<30 days) were evaluated in terms of mortality, stroke and cranial nerves' injury and compared between the two groups with χ(2) test. Follow-up results (stroke free-survival, freedom from ICA thrombosis and reintervention) were analysed with Kaplan-Meier curves and compared with log-rank test.
  
  
  RESULTS
  All the patients in group 1 had open repair of their ICA aneurysm; in group 2 open repair was performed in 30 cases, while three patients with post-CEA aneurysm without signs of infection had a covered stent placed. There were no perioperative deaths. Two major strokes occurred in group 1 and one major stroke occurred in group 2 (p = 0.1). The rates of postoperative cranial nerve injuries were 10.5% in group 1 and 13% in group 2 (p = 0.8). Median duration of follow-up was 60 months (range 1-276). Estimated 10-year stroke-free survival rates were 64% in group 1 and 37% in group 2 (p = 0.4, log rank 0.5); thrombosis-free survival at 10 years was 66% in group 1 and 34% in group 2 (p = 0.2, log rank 1.2), while the corresponding figures in terms of reintervention-free survival were 68% and 33%, respectively (p = 0.2, log rank 1.8).
  
  
  CONCLUSIONS
  Surgical treatment of ICA aneurismal disease provided in our experience satisfactory early and long-term results, without significant differences between true and false aneurysms. In carefully selected patients with non-infected false aneurysm, the endovascular option seems to be feasible.
authors.affiliation: Department of Vascular Surgery, University of Florence, Viale Morgagni 85, 50134 Florence, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Pulli
authors.forename: W
authors.initials: W
authors.lastname: Dorigo
authors.forename: A
authors.initials: A
authors.lastname: Alessi Innocenti
authors.forename: G
authors.initials: G
authors.lastname: Pratesi
authors.forename: A
authors.initials: A
authors.lastname: Fargion
authors.forename: C
authors.initials: C
authors.lastname: Pratesi
mesh_terms: D000368:Aged; D000783:Aneurysm / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D002340:Carotid Artery Diseases / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D020212:Carotid Artery Injuries / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000601:surgery*; D016009:Chi-Square Distribution; D020209:Cranial Nerve Injuries / Q000209:etiology; D018572:Disease-Free Survival; D057510:Endovascular Procedures / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006801:Humans; D007558:Italy; D053208:Kaplan-Meier Estimate; D008297:Male; D018579:Patient Selection; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000209:etiology; D013927:Thrombosis / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000401:mortality