Surgical repair of cervical internal carotid artery aneurysm in a patient with suspected connective tissue disorder
DOI:
https://doi.org/10.48750/acv.601Keywords:
carotid artery, aneurysm, connective tissue disorderAbstract
BACKGROUND: We present an uncommon case of open surgical treatment of an impacting extra-cranial internal carotid artery aneurysm in a 65-year-old female patient which represented the tip of a large iceberg, in this case, presence of a connective tissue disorder (CTD).CASE REPORT: Data regarding medical and family history were collected. The patient was referred to our institution due to left latero-cervical mass. Computed tomography angiography showed a large saccular aneurysm of the left internal carotid artery. Open surgical treatment was performed by aneurysmorrhaphy and end-to-end anastomosis. A section of the carotid aneurysmal wall was sent for histological investigation. The patient was discharged with no neurological issues or cranial nerve injuries. Histological examination of the tissue revealed morphological findings suggestive of a severe degenerative disease.
CONCLUSION: The successful treatment for extracranial carotid artery aneurysm (ECAA) is determined by the carotid artery anatomy and aneurysm properties. The need for early diagnosis and extensive examination in patients with ECAA, as well as clinical suspicion of CTD, plays a crucial role in identifying individuals at risk and guiding optimal management strategies and follow-up.
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Amy M; M. Walter;Murray M. Flett;John Nagy;Stuart A. Suttie;Andrew Dalton;Matthew Casey;Graeme J. K. Guthrie; (2021). Giant Carotid Artery Aneurysm . Vascular and Endovascular Surgery,
Ohyama, Takashiro; OHARA, Susumu; MOMMA, Fumiyuki (1992). Aneurysm of the Cervical Internal Carotid Artery Associated with Marfan''s Syndrome —Case Report—. Neurologia medico-chirurgica, 32(13), 965–968.
Karan G, Rockman Caron B, Victoria L, et al. Presentation and management of carotid artery aneurysms and pseudoaneurysms. J Vasc Surg. 2012; 55(6):1618-1622.
Painter TA, Hertzer NR, Beven EG, O’Hara PJ. Extracranial carotid aneurysms: report of six cases and review of the literature. J Vasc Surg 1985;2:312-8.
Hertzer NR. Extracranial carotid aneurysms: a new look at an old problem. J Vasc Surg 2000;31:823-5.
Beall AC, Jr, Crawford ES, Cooley DA, Debakey ME. Extracranial aneurysms of the carotid artery: report of seven cases. Postgrad Med. 1962;32:93-102.
Sfyroeras, George S.; Nikolopoulou, Eleni Aliki; Moulakakis, Konstantinos G.; Lazaris, Andreas M.; Kakisis, John D.; Geroulakos, George (2019). Extracranial internal carotid artery aneurysm in a patient with Marfan Syndrome.. Annals of Vascular Surgery
Hernandez JG, Bertomeu AB, Caseriego CV, Martinez AB, Hernandez-Avila C, March JR. Acute non-ruptured expansion of extracranial carotid artery aneurysm. an infrequent clinical presentation. Ann of Vasc. 2021;66.
Ben Jmaà, Hèla; Lagha, Amal; Diope, Abdellaziz; Jarraya, Fatma; Bouchech, Bouthaina; Masmoudi, Sayda; Boudawara, Tahia; Elleuch, Nizar; Frikha, Imed (2018). Surgical management of internal carotid artery aneurysm near the skull base. JMV-Journal de Médecine Vasculaire, 43(4), 262–266
D.Mascia, S. A. Gabriel, A. Kahlberg, L. Bertoglio, G. Melissano, R. Chiesa. Single-Center experience with extracranial carotid aneurysm open repair. The Journal of Cardiovascular Surgery, 2020 February;61(1)47-52
Qiu, Jiehua; Zhou, Weimin; Zhu, Xianhua; Zhou, Wei; Zeng, Qinfu; Huang, Li; Tang, Xinhua; Yuan, Qingwen (2020). Treatment of Extracranial Carotid Artery Aneurysm: Fifteen years experience at A Single Institution. Annals of Vascular Surgery j.avsg.2020.05.052
Carotid Artery Tortuosity Is Associated with Connective Tissue Diseases. J P Welby , S T Kim, C M Carr, V T Lehman, C H Rydberg, J T Wald, P H Luetmer, D.M.Nasr, W.Brinjikji; AJNR Am J Neuroradiol 2019 Oct;40(10):1738-1743
Welleweerd, J.C.; den Ruijter, H.M.; Nelissen, B.G.L.; Bots, M.L.; Kappelle, L.J.; Rinkel, G.J.E.; Moll, F.L.; de Borst, G.J. (2015). Management of Extracranial Carotid Artery Aneurysm. European Journal of Vascular and Endovascular Surgery, 50(2), 141–147.
Surgical Therapy of Extracranial Carotid Artery Aneurysms: Long-Term Results over 24-Year Period N. Attigah a, S. Külkens b, N. Zausig c, J. Hansmann c, P. Ringleb b, M. Hakimi a, H.-H. Eckstein d, J.-R. Allenberg a, D. Böckler European Journal of Vascular and Endovascular Surgery Volume 37, Issue 2, February 2009, Pages 127-133
Endovascular Stenting of Extracranial Carotid Artery Aneurysm: A Systematic Review Z. Li a, G. Chang a, C. Yao a, L. Guo a, Y. Liu b, M. Wang a, D. Liu a, S. Wang a European Journal of Vascular and Endovascular Surgery Volume 42, Issue 4, October 2011, Pages 419-426
Karan Garg; Caron B. Rockman; Victoria Lee; Thomas S. Maldonado; Glenn R. Jacobowitz; Mark A. Adelman; Firas F. Mussa (2012). Presentation and management of carotid artery aneurysms and pseudoaneurysms. , 55-60-F. the Eastern Vascular Society
Painter TA, Hertzer NR, Beven EG, O’Hara PJ. Extracranial carotid aneurysms: report of six cases and review of the literature. J Vasc Surg 1985;2:312-8.
Han HC. Twisted blood vessels: symptoms, etiology and biomechanical mechanisms. J Vasc Res 2012;49:185–97
Kim ST, Brinjikji W, Lanzino G, et al. Neurovascular manifestations of connective–tissue diseases: a review. Interv Neuroradiol 2016;22:624–37