SURGICAL-MANAGEMENT OF EXTRACRANIAL CAROTID-ARTERY ANEURYSMS - ANALYSIS OF 6 CASES

This article reviews the clinical manifestations, operative techniques, results and complications associated with the tratment of 6 extracranial carotid-artery aneurysms during experience with 434 carotid endarterectomies over a 10-year period. The etiology was atherosclerosis in 4 cases, posttraumatic in 1, and congenital in 1 other case. All patients were operated on because of symptomatic disease. Four patients had resection of their aneurysm with end-to-end anastomosis. 1 with saphenous-vein patch. One patient had aneurysmorrhaphy. There were no hospital deaths. Two patients had a hemiparesis prior to the operation; this manifestation disappeared slowly in both patients, but residual neurological deficit was present in 1 patient 2 years postoperatively. One patient developed transient neurological symptoms. We conclude that accessible aneurysms of the extracranial carotid artery can be operated with acceptable morbidity and mortality. Operative management is the treatment of choice, because these lesions are attended by a high incidence of neurological complications if left untreated.