title: Surgical management of extracranial carotid artery aneurysms.
abstract: BACKGROUND
  We present the methods and results of the surgical management of extracranial carotid artery aneurysms (ECCA). Postoperative complications including early and late neurological events were analysed. Correlation between reconstruction techniques and morphology of ECCA was assessed in this retrospective study.
  
  
  METHODS
  In total, 32 reconstructions of ECCA were performed in 31 symptomatic patients with a mean age of 59.2 (range 33-84) years. The causes of ECCA were divided among atherosclerosis (n = 25; 78.1%), previous carotid endarterectomy with Dacron patch (n = 4; 12.5%), iatrogenic injury (n = 2; 6.3%) and infection (n = 1; 3.1%). In 23 cases, intervention consisted of carotid bypass. Aneurysmectomy with end-to-end suture was performed in 4 cases. Aneurysmal resection with patching was done in 2 cases and aneurysmorrhaphy without patching in another 2 cases. In 1 case, ligature of the internal carotid artery (ICA) was required.
  
  
  RESULTS
  Technical success defined as the preservation of ICA patency was achieved in 31 cases (96.9%). There was one perioperative death due to major stroke (3.1%). Two cases of minor stroke occurred in the 30-day observation period (6.3%). Three patients had a transient hypoglossal nerve palsy that subsided spontaneously (9.4%). At a mean long-term follow-up of 68 months, there were no major or minor ipsilateral strokes or surgery-related deaths reported. In all 30 surviving patients (96.9%), long-term clinical outcomes were free from ipsilateral neurological symptoms.
  
  
  CONCLUSIONS
  Open surgery is a relatively safe method in the therapy of ECCA. Surgical repair of ECCAs can be associated with an acceptable major stroke rate and moderate minor stroke rate. Complication-free long-term outcomes can be achieved in as many as 96.9 % of patients. Aneurysmectomy with end-to-end anastomosis or bypass surgery can be implemented during open repair of ECCA.
authors.affiliation: 1 Department of Vascular, General and Transplantation Surgery, Wrocław Medical University, Wroclaw, Poland.
authors.forename: Jan Paweł
authors.initials: JP
authors.lastname: Skóra
authors.affiliation: 2 Department of General and Interventional Radiology and Neuroradiology, Wrocław Medical University, Wroclaw, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Kurcz
authors.affiliation: 1 Department of Vascular, General and Transplantation Surgery, Wrocław Medical University, Wroclaw, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Korta
authors.affiliation: 1 Department of Vascular, General and Transplantation Surgery, Wrocław Medical University, Wroclaw, Poland.
authors.forename: Przemysław
authors.initials: P
authors.lastname: Szyber
authors.affiliation: 1 Department of Vascular, General and Transplantation Surgery, Wrocław Medical University, Wroclaw, Poland.
authors.forename: Tadeusz Andrzej
authors.initials: TA
authors.lastname: Dorobisz
authors.affiliation: 1 Department of Vascular, General and Transplantation Surgery, Wrocław Medical University, Wroclaw, Poland.
authors.forename: Andrzej Tadeusz
authors.initials: AT
authors.lastname: Dorobisz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D002340:Carotid Artery Diseases / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000401:mortality
keywords: Extracranial carotid aneurysm; aneurysm; stroke; surgical treatment