Hostname: page-component-76fb5796d-vfjqv Total loading time: 0 Render date: 2024-04-25T08:22:38.598Z Has data issue: false hasContentIssue false
  • English
  • Français

Open and endovascular repair of aneurysms affecting the distal extracranial internal carotid artery: case series

Published online by Cambridge University Press:  04 August 2016

P Mukherjee ,
R Huilgol ,
A Graham  and
P Fagan
P Mukherjee*
Affiliation:
Department of Surgery, University of Sydney, Sydney, Australia
R Huilgol
Affiliation:
Department of Vascular Surgery, St Vincent's Hospital, Sydney, Australia
A Graham
Affiliation:
Department of Vascular Surgery, St Vincent's Hospital, Sydney, Australia
P Fagan
Affiliation:
Department of Otology, Neurotology and Skull Base Surgery, St Vincent's Hospital, Sydney, Australia
*
Address for correspondence: Dr Payal Mukherjee, PO Box 1384, Wahroonga, Sydney 2076, Australia Fax: +61 2 9747 1499 E-mail: payal.mukherjee@sydney.edu.au
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Three cases of internal carotid artery aneurysm affecting the distal cervical segment were retrospectively reviewed.

Methods:

Two patients underwent open surgical repair requiring petrous segment exposure for bypass of the affected segment using a Fisch type A lateral skull base approach. The third patient underwent endovascular stenting.

Results:

There were no cerebrovascular complications post-operatively. Both open repair patients experienced temporary lower cranial nerve palsies. One required facial nerve grafting. All patients had patent grafts at follow up. The stent graft patient had a small endoleak at six months.

Conclusion:

Endovascular and open approaches both have advantages and disadvantages. Treatment needs to be tailored to the lesion and the patient. An open surgical approach is difficult but well established. Endovascular treatment of these lesions is a relatively recent technique, and new cases need to be continually reported with a view to attaining long-term data.

Keywords

Internal Carotid ArteryAneurysmPetrous Segment ExposureOpen RepairEndovascular RepairMorbidity
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Supplement S4 , July 2016 , pp. S29 - S34
Copyright
Copyright © JLO (1984) Limited 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Pirvu, A, Bouchet, C, Garibotti, FM, Haupert, S, Sessa, C. Mycotic aneurysm of the internal carotid artery. Ann Vasc Surg 2013;27:826–30CrossRefGoogle ScholarPubMed
2 Martens, S, Beelen, R, Degrieck, I. Mycotic aneurysm of the extracranial carotid artery: a case report and review of the literature. Acta Chir Belg 2011;111:97–9Google Scholar
3 Reslan, OM, Ebaugh, JL, Raffetto, JD. Bilateral asymptomatic extracranial carotid artery aneurysms. Ann Vasc Surg 2010;24:691.e11–16Google Scholar
4 Keshelava, G, Mikadze, I, Abzianidze, G, Kakabadze, Z. Petrous carotid artery's in situ bypass: anatomic study. World J Surg 2008;32:639–41Google Scholar
5 Li, Z, Chang, G, Yao, C, Guo, L, Liu, Y, Wang, M et al. Endovascular stenting of extracranial carotid artery aneurysm: a systematic review. Eur J Vasc Endovasc Surg 2011;42:419–26CrossRefGoogle ScholarPubMed
6 Malikov, S, Thomassin, JM, Margan, PE, Keshalava, G, Bartoli, M, Branchereau, A. Open surgical reconstruction of the internal carotid artery aneurysm at the base of the skull. J Vasc Surg 2010;51:323–9Google Scholar
7 Fisch, U, Fagan, P, Valavanis, A. The infratemporal fossa approach for the lateral skull base. Otolaryngol Clin North Am 1984;17:513–52Google Scholar
8 Winslow, N. Extracranial aneurysm of the internal carotid artery: history and analysis of the cases registered up to August 1925. Arch Surg 1926;13:689–729 Google Scholar
9 Zwolak, RM, Whitehouse, WM, Knake, JE, Bernfeld, BD, Zelenock, GB, Cronenwett, JL. Atherosclerotic extracranial carotid artery aneurysms. J Vasc Surg 1984;1:415–22Google Scholar
10 Windfuhr, JP. Aneurysm of internal carotid artery following soft tissue penetration injury. Int J Pediatr Otorhinolaryngol 2001;61:155–9Google Scholar
11 Landolt, AM, Millikan, CH. Pathogenesis of cerebral infarction secondary to mechanical carotid artery occlusion. Stroke 1970;1:52–62 Google Scholar
12 Liu, J, Couldwell, WT. Interpositional carotid artery bypass strategies in the surgical management of aneurysms and tumors of the skull base. Neurosurg Focus 2003;14:e2 Google Scholar
13 Linskey, ME, Jungreis, CA, Yonas, H, Hirsch, WL Jr, Sekhar, LN, Horton, JA et al. Stroke risk after abrupt internal carotid artery sacrifice: accuracy of preoperative assessment with balloon test occlusion and stable xenon-enhanced CT. AJNR Am J Neuroradiol 1994;15:829–43Google ScholarPubMed
14 Sekhar, LN, Patel, SJ. Permanent occlusion of the internal carotid artery during skull-base and vascular surgery: is it really safe? Am J Otol 1993;14:421–2Google ScholarPubMed
15 Tsai, TC, Barot, N, Dalman, R, Mihm, F. Combined endovascular and open operative approach for mycotic carotid aneurysm. J Vasc Surg 2010;51:1514–16Google Scholar
16 Attigah, N, Külkens, S, Zausig, N, Hansmann, J, Ringleb, P, Hakimi, M et al. Surgical therapy of extracranial carotid artery aneurysms: long-term results over a 24-year period. Eur J Vasc Endovasc Surg 2009;37:127–33Google Scholar
17 Tate, J, Tollefson, T. Advances in facial reanimation. Curr Opin Otolaryngol Head Neck Surg 2006;14:242–8Google Scholar
18 Kfoury, E, Patel, S, Mukherjee, D. Carotid endarterectomy under local anaesthesia: an alternative treatment for carotid stenosis. Vascular Disease Management 2012;9:E193–7 Google Scholar
19 Zhu, W, Tian, YL, Zhou, LF, Song, DL, Xu, B, Mao, Y. Treatment strategies for complex internal carotid artery (ICA) aneurysms: direct ICA sacrifice or combined with extracranial-to-intracranial bypass. World Neurosurg 2011;75:476–84Google Scholar
20 Howell, SH, Baburao, T, Graziano, J. Mycotic cervical carotid aneurysm. Surgery 1977;81:357–9Google Scholar
21 Patel, S, Johnston, KW. Classification and management of mycotic aneurysms. Surg Gynecol Obstet 1977;144:691–4Google Scholar
22 Grossi, RJ, Onofrey, D, Tvetenstrand, C. Mycotic carotid aneurysm. J Vasc Surg 1987;6:81–3Google Scholar
23 Monsoon, RC II, Alexander, RH. Vein reconstruction of a mycotic internal carotid aneurysm. Ann Surg 1980;191:47–50 CrossRefGoogle Scholar
24 Jebara, VA, Acar, C, Dervanian, P, Chachques, JC, Bischoff, N, Uva, MS et al. Mycotic aneurysm of the carotid arteries – a case report and review of the literature. J Vasc Surg 1991;14:215–19CrossRefGoogle ScholarPubMed
25 Huilgol, RL, Young, J, Lemech, L, Stephen, MS, May, J, Harris, JP et al. Durability of autogenous vein and polytetrafluoroethylene bypass grafts to the carotid arteries. ANZ J Surg 2006;76:878–81Google Scholar
26 Macina, AS, Vidjak, V, Erdelez, L, Suknaic, S, Gašparov, S, Novacic, K. Open surgical and endovascular treatment of extracranial internal carotid artery aneurysms. Perspect Vasc Surg Endovasc Ther 2009;21:181–5CrossRefGoogle ScholarPubMed
27 Heye, S, Maleux, G, Vandenberghe, R, Wilms, G. Symptomatic internal carotid artery dissecting pseudoaneurysm: endovascular treatment by stent-graft. Cardiovasc Intervent Radiol 2005;28:499–501 Google Scholar
28 Zhou, W, Lin, PH, Bush, RL. Carotid artery aneurysm: evolution of management over two decades. J Vasc Surg 2006;43:493–6Google Scholar