title: Treatment strategies for carotid artery aneurysms.
abstract: BACKGROUND
  The aim of this paper was to present single centre experience in the treatment of extra cranial carotid artery aneurysms (ECCA) and to analyze results discussing different treatment modalities.
  
  
  METHODS
  The study analyzed 60 patients with 62 ECCA treated surgically at the Clinic for vascular and endovascular surgery, Serbian Clinical Center (Belgrade) in the period between 1985 and 2013. Treatment strategy was individually selected and demographic, morphologic, intraoperative and postoperative data were collected.
  
  
  RESULTS
  Thirty-day operative mortality was 3.3% and completely stroke related. Besides two fatal strokes one additional was registered making total number of 3 (4.8%) postoperative strokes. Only one (1.6%) early graft thrombosis has been found. The 30-day-patency rate was 98.4%. During the same period seven local complications were found: three (4.8%) hemorrhage and four (6.4%) cranial nerves injuries. In all cases of hemorrhage successful re-intervention was performed without any consequences. Cranial nerves injuries included transient contusions of hypoglossal (2) and superior laryngeal nerve (2).
  
  
  CONCLUSIONS
  The etiology, location, and morphology of an ECCA are determining selection of appropriate therapy. Large or tortuous aneurysms, as well as aneurysms involving common carotid or proximal internal carotid artery, are also absolutely indicated to open surgical therapy. Aneurysms which involve the distal internal carotid artery and false anastomotic aneurysms are best managed with endovascular techniques. The ligature is indicated for the treatment of external carotid aneurysms, mycotic aneurysms with local infection and in ruptured ECCA with uncontrolled bleeding.
authors.affiliation: Faculty of Medicine, University of Belgrade, Belgrade, Serbia - davidovic.lazar@gmail.com.
authors.forename: Lazar
authors.initials: L
authors.lastname: Davidovic
authors.forename: Igor
authors.initials: I
authors.lastname: Koncar
authors.forename: Marko
authors.initials: M
authors.lastname: Dragas
authors.forename: Nikola
authors.initials: N
authors.lastname: Ilic
authors.forename: Igor
authors.initials: I
authors.lastname: Banzic
authors.forename: Sinisa U
authors.initials: SU
authors.lastname: Pavlovic
authors.forename: Miroslav
authors.initials: M
authors.lastname: Markovic
authors.forename: Natasa
authors.initials: N
authors.lastname: Ristanovic
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D002340:Carotid Artery Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D000072226:Computed Tomography Angiography; D057510:Endovascular Procedures / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006801:Humans; D008026:Ligation; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D018579:Patient Selection; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D055771:Serbia; D020521:Stroke / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D014680:Veins / Q000637:transplantation*