Extracranial carotid artery aneurysm and surgical treatment

Özet

Objectives: This study aims to investigate clinical, laboratory, and neurological data and operations of the patients in patients with an extracranial carotid artery aneurysm (ECCA). Patients and methods: A total of 14 patients (11 males, 3 females; mean age: 61.6±6.3 years; range, 48 to 70 years) who were operated for an ECCA in our clinic between January 2011 and January 2021 were retrospectively analyzed. Color Doppler ultrasound (CDUS) and computed tomography angiography (CTA) were used to evaluate the patients. Data regarding patient characteristics, strokes, mortality, obstructions, and other surgical complications, as well as preoperative atherosclerotic risk factors, were recorded. Results: The surgically operated lesions were located on one side of the neck in all patients; particularly, they were located on the left side in three (22%) patients and on the right in 11 (78%) patients. The most common type of ECCA in all patients was Type 1 (saccular), and aneurysms were reported to be present only in the internal carotid artery. Primary end-to-end repair was performed in 11 (78%), saphenous vein graft interposition in two (14%), and synthetic graft in one (8%) patient. The mean length of stay in the intensive care unit was 2.1±0.4 days, the mean length of the hospital stay was 87±0.64 days, and the mean amount of drainage in the first two postoperative days was 24.4±10.8 mL. Bleeding at the wound site occurred in one patient due to the skin incision and was eliminated via suturing. A hematoma at the wound site was observed in one patient, and redness at the wound site was observed in one patient and disappeared prior to discharge with the treatments applied. The neurological examination revealed a temporary facial shift in one patient that resolved before discharge. Conclusion: The natural course of ECCAs is still not well understood, and there is no definitive consensus about their treatment. The main goal of managing ECCAs is to prevent aneurysms. They are rare entities and may occur with or without various symptoms. Early and long-term outcomes of invasive treatment of ECCAs are favorable.