P Szopinski1, P Ciostek, M Kielar, P Myrcha, E Pleban, W Noszczyk. 1. I Chair and Clinic of General and Vascular Surgery, Medical University of Warsaw, Kondratowicza 8, 03242 Warsaw, Poland. piotr.szopinski@neostrada.pl
Abstract
OBJECTIVES: This is a retrospective review of 15 patients with primary and secondary aneurysms of extracranial carotid arteries treated surgically and endoluminally over 20 years in one centre. PATIENTS AND METHODS: Fifteen aneurysms of extracranial carotid arteries were noticed in the same number of patients: five atherosclerotic, two after previous carotid surgery, six post-traumatic, one inflammatory, one of unknown etiology. All of them were symptomatic. RESULTS: In the group treated surgically some complications occurred in the perioperative time: one haematoma, two transient neurological deficits, one fatal stroke. In the endovascular group of patients no complications occurred after the treatment. One fatal stroke occurred during operation-the patient died on the 43rd postoperative day due to respiratory insufficiency. Two other deaths occurred during the follow-up: one caused by myocardial infarction 10 years after the aneurysm resection, and the second due to a fatal stroke 3 years after aneurysmorraphy. One patient refused treatment and died 9 months after being diagnosed. CONCLUSION: Neurological deficits in patients after neck injuries should arouse the suspicion of the presence of a carotid artery aneurysm. Open repair remains the method of choice in treating carotid artery aneurysms but endovascular procedures create the possibility of treating extracranial aneurysms in selected cases when open surgery is not recommended.
OBJECTIVES: This is a retrospective review of 15 patients with primary and secondary aneurysms of extracranial carotid arteries treated surgically and endoluminally over 20 years in one centre. PATIENTS AND METHODS: Fifteen aneurysms of extracranial carotid arteries were noticed in the same number of patients: five atherosclerotic, two after previous carotid surgery, six post-traumatic, one inflammatory, one of unknown etiology. All of them were symptomatic. RESULTS: In the group treated surgically some complications occurred in the perioperative time: one haematoma, two transient neurological deficits, one fatal stroke. In the endovascular group of patients no complications occurred after the treatment. One fatal stroke occurred during operation-the patient died on the 43rd postoperative day due to respiratory insufficiency. Two other deaths occurred during the follow-up: one caused by myocardial infarction 10 years after the aneurysm resection, and the second due to a fatal stroke 3 years after aneurysmorraphy. One patient refused treatment and died 9 months after being diagnosed. CONCLUSION:Neurological deficits in patients after neck injuries should arouse the suspicion of the presence of a carotid artery aneurysm. Open repair remains the method of choice in treating carotid artery aneurysms but endovascular procedures create the possibility of treating extracranial aneurysms in selected cases when open surgery is not recommended.