Ben Jmaà Hèla, Lagha Amal, Diope Abdellaziz, Jarraya Fatma, Bouchech Bouthaina, Masmoudi Sayda, Boudawara Tahia, Elleuch Nizar, Frikha Imed
Department of cardiovascular and thoracic surgery, Habib Bourguiba hospital, 3029 Sfax, Tunisia.
Department of cardiovascular and thoracic surgery, Habib Bourguiba hospital, 3029 Sfax, Tunisia.
J Med Vasc. 2018 Jul;43(4):262-266. doi: 10.1016/j.jdmv.2018.04.003.
Extracranial carotid artery aneurysms are rare. The most common location is the common carotid artery near the bifurcation. The mid to distal internal carotid artery is the second most common location. We are reporting the case of a 64-year-old woman who was admitted to our department for management of an asymptomatic left internal carotid artery aneurysm. Physical examination revealed a pulsatile mass, and imaging confirmed the aneurysm diagnosis. Computed tomography angiography detailed a 28mm×3cm×6cm aneurysm of the left cervical internal carotid artery with tortuous outflow the aneurysm sac. Open repair was undertaken. Exposure with incision anterior to the sternocleidomastoid was performed although extended more superiorly than usual because of the distal aneurysm location. After carotid clamping, the aneurysm was resected and an end-to-end anastomosis with prosthesis was performed. After closure, the patient was extubated demonstrating baseline neurologic function. Histologic examination of the arterial wall confirmed the diagnosis of fibromuscular dysplasia.
颅外颈动脉动脉瘤较为罕见。最常见的部位是靠近分叉处的颈总动脉。颈内动脉中远端是第二常见的部位。我们报告一例64岁女性患者，因无症状性左颈内动脉动脉瘤入住我科。体格检查发现一个搏动性肿块，影像学检查确诊为动脉瘤。计算机断层血管造影详细显示左颈内动脉有一个28mm×3cm×6cm的动脉瘤，瘤囊流出道迂曲。进行了开放修复。尽管由于动脉瘤位于远端，切口比通常更向上延长，但仍在胸锁乳突肌前方进行了暴露。夹闭颈动脉后，切除动脉瘤并进行了人工血管端端吻合。缝合后，患者拔除气管插管，神经功能恢复至基线水平。动脉壁组织学检查确诊为纤维肌发育不良。
