Robaldo Alessandro, Persi Federica, Trucco Andrea, Apostolou Dimitri
Vascular Surgery Unit, Santa Croce and Carle Hospital, Via Michele Coppino 26, 12100, Cuneo, Italy.
Ann Med Surg (Lond). 2021 Apr 16;65:102321. doi: 10.1016/j.amsu.2021.102321. eCollection 2021 May.
Extracranial carotid aneurysms (ECCAs) are relatively uncommon. Most of these lesions are due to atherosclerosis, trauma, infection, radiotherapy, previous surgery or iatrogenic event. Severe complications include rupture, dysphagia, respiratory symptoms and brain embolization.
We report a case of a large saccular aneurysm of the extracranial internal carotid artery (EICA) in a 83-year old asymptomatic woman without any apparent causative history. The patient underwent a successful repair of the aneurysm by aneurysmectomy and primary end-to-end anastomosis between the proximal and distal portion of the remaining vessel with continuity restored without tension.
ECCAs are rare with few cases reported in the most recent literature. There is little knowledge of their natural history and management. Both surgical and endovascular as well as medical treatments have been recommended depending on disease-location and comorbidities.
Although treatment should be individualized time by time by evaluating patient's characteristics, the surgical repair could be a safe and effective solution to treat distal EICAs, especially for symptomatic and true growing lesions. The presentation, the diagnostic evaluation, and the successful surgical treatment are discussed.
颅外颈动脉动脉瘤（ECCA）相对少见。这些病变大多由动脉粥样硬化、创伤、感染、放疗、既往手术或医源性事件引起。严重并发症包括破裂、吞咽困难、呼吸道症状和脑栓塞。
我们报告一例83岁无症状女性的颅外颈内动脉（EICA）大型囊状动脉瘤，无任何明显病因病史。患者通过动脉瘤切除术成功修复动脉瘤，并在剩余血管的近端和远端之间进行了一期端端吻合，恢复连续性且无张力。
ECCA罕见，近期文献报道的病例很少。对其自然史和治疗知之甚少。根据病变位置和合并症，推荐了手术、血管内治疗以及药物治疗。
尽管应通过评估患者特征逐案进行个体化治疗，但手术修复可能是治疗远端EICA的安全有效方法，特别是对于有症状和真正进展性病变。本文讨论了该病例的表现、诊断评估及成功的手术治疗。
