Surgical management of extracranial carotid artery aneurysms.
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.


PATIENTS AND 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.
['Skóra|Jan Paweł|JP|', 'Kurcz|Jacek|J|', 'Korta|Krzysztof|K|', 'Szyber|Przemysław|P|', 'Dorobisz|Tadeusz Andrzej|TA|', 'Dorobisz|Andrzej Tadeusz|AT|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D000783:Aneurysm D002340:Carotid Artery Diseases D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D012189:Retrospective Studies D018570:Risk Assessment D012307:Risk Factors D020521:Stroke D013997:Time Factors D016896:Treatment Outcome D014656:Vascular Surgical Procedures
aneurysm stroke Extracranial carotid aneurysm surgical treatment