title: Surgical and Endovascular Treatments of Extracranial Carotid Artery Aneurysms-Report of Six Cases.
abstract: BACKGROUND
  Although the natural course of extracranial carotid artery aneurysms (ECAAs) is still unknown, they may cause stroke or cranial nerve dysfunction unless they are treated. In this report, we reviewed the clinical results of 6 patients who underwent endovascular and surgical treatments for ECAAs.
  
  
  METHODS
  A total of 6 patients underwent endovascular and surgical treatments for ECAAs for 9 years. The primary causes of ECAAs included Marfan syndrome (1 patient), infection (1 patient), trauma (2 patients), and unknown (2 patients). All 6 ECAAs were symptomatic.
  
  
  RESULTS
  One patient underwent surgical resection of the ECAA followed by end-to-end anastomosis of the internal carotid artery (ICA). Another patient underwent proximal ICA ligation combined with high-flow external carotid artery-to-middle cerebral artery bypass using a radial artery graft, because the patient also had a giant thrombosed aneurysm in the cavernous portion of the ipsilateral ICA. Endovascular treatment was selected in the other 4 patients using a covered stent or a bare metal stent combined with coil embolization. Of these patients, one required proximal ICA ligation followed by superficial temporal artery-to-middle cerebral artery anastomosis due to an anatomical problem for stent placement. There was no neurological deterioration at the discharge in all but 1 patient who suffered ischemic stroke during surgery.
  
  
  CONCLUSIONS
  Surgical or endovascular treatment yielded a relatively satisfactory outcome in patients with ECAAs.
authors.affiliation: Department of Neurosurgery, Graduate School of Medicine and Pharmaceutical Science, University of Toyama, Toyama, Japan. Electronic address: s.yamamoto1007@gmail.com.
authors.forename: Shusuke
authors.initials: S
authors.lastname: Yamamoto
authors.affiliation: Department of Neurosurgery, Graduate School of Medicine and Pharmaceutical Science, University of Toyama, Toyama, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Akioka
authors.affiliation: Department of Neurosurgery, Graduate School of Medicine and Pharmaceutical Science, University of Toyama, Toyama, Japan.
authors.forename: Daina
authors.initials: D
authors.lastname: Kashiwazaki
authors.affiliation: Department of Neurosurgery, Graduate School of Medicine and Pharmaceutical Science, University of Toyama, Toyama, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Koh
authors.affiliation: Department of Neurosurgery, Graduate School of Medicine and Pharmaceutical Science, University of Toyama, Toyama, Japan.
authors.forename: Naoya
authors.initials: N
authors.lastname: Kuwayama
authors.affiliation: Department of Neurosurgery, Graduate School of Medicine and Pharmaceutical Science, University of Toyama, Toyama, Japan; Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kuroda
mesh_terms: D000328:Adult; D000368:Aged; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000601:surgery*; D000072226:Computed Tomography Angiography; D038524:Diffusion Magnetic Resonance Imaging; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000295:instrumentation; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008026:Ligation; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D017534:Radial Artery / Q000637:transplantation*; D015607:Stents; D016896:Treatment Outcome; D058017:Vascular Grafting / Q000009:adverse effects / Q000379:methods*; D055815:Young Adult
keywords: Extracranial carotid artery aneurysm; bypass surgery; covered stent; endovascular treatment