Surgical treatment of the extracranial carotid artery aneurysm

Abstract

Aneurysm of the extracranial carotid artery is rare. 13 cases have been seen at the Vascular Diseases Research Unit, Department of Surgery, Zhongshan Hospital, Shanghai First Medical College, during the past 27 years. There were 3 internal carotid, 1 external carotid and 9 common carotid cases. The youngest patient was aged 5 years and the oldest 63; there were 8 males and 5 females. Two refused surgery, and the remaining 11 all had operations. Treatment consisted of aneurysm resection with ligation of the carotid artery in 5, primary anastomosis of the internal carotid artery in 2, silk prosthetic graft of the common carotid artery in 1, autogenous vein graft between the common and internal carotid arteries in 2 and wrapping in 1. There was 1 death and 1 instance of hemiplegia.

Prior to arterial reconstruction, the only possible treatment for aneurysm was ligation. The hazards of carotid artery ligation are evident from the fact that hemiplegia results in 50% of the patients.

In this series, a variety of methods were utilized to maintain cerebral function during the period of temporary carotid artery occlusion including hypothermic general anesthesia in 10 cases and raise the blood pressure during occlusion in 2 cases. In recent years, the authors have successfully resected the aneurysm and inserted an autogenous saphenous vein graft. With this technique the duration of cerebral ischemia is minimal.

Keywords

carotid artery / artery aneurysm

References

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